NPIMap

Individual provider Active NPI

Brad D. Blankenhorn, M.D.

  • Orthopaedic Surgery Physician
  • East Providence, RI
National Provider Identifier
1003033119
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD13206 Issued in RI
Practice address
1 Kettle Point Ave
East Providence, RI 02914-5375
Phone
(401) 330-1405
Fax
(401) 277-0799
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2012-0546 NM
Orthopaedic Surgery Physician 207X00000X MD13206 RI Primary

Addresses

Primary practice location

1 Kettle Point Ave
East Providence, RI 02914-5375

Mailing address

PO Box 1119
Providence, RI 02901-1119
Phone (401) 330-1405

Other identifiers 2

IdentifierTypeStateIssuer
110087299AOtherRIMASSHEALTH
BB81009MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100706000637 RI Practitioner - Orthopedic Surgery 0749311801 Reassigns benefits to 1 organization
I20220324001219 MA Practitioner - Orthopedic Surgery 0749311801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2012-0546NMMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopedics, Inc. Orthopaedic Surgery CurrentSince Jul 1, 2010 Accepting new patients
University Orthopedics, Inc. Orthopaedic Surgery CurrentSince Jan 15, 2021 Accepting new patients
University Orthopedics, Inc. Orthopaedic Surgery CurrentSince Jul 1, 2010 Accepting new patients
University of Utah Orthopedic Consultants Orthopaedic Surgery Past Accepting new patients

Locations

10 Reservoir St
Ste 101
Mansfield, MA 02048
Phone (508) 618-7111

1 Kettle Point Ave
East Providence, RI 02914
Phone (401) 330-1400

2 Dudley St
Ste 200
Providence, RI 02905
Phone (401) 457-1504

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGDFCA
  • Direct secure messaging: brad.blankenhorn.1@13709.direct.athenahealth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Pittsburgh School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopedics Inc 185 clinicians

Practice addresses (Care Compare)

10 Reservoir St
Suite 101
Mansfield, MA 02048-3104
Phone (508) 618-7111

2 Dudley St
Suite 200
Providence, RI 02905-3248
Phone (401) 457-1500

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Newport Hospital Hospital, Newport, RI, CCN 410006

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.76
Promoting interoperability
96
Improvement activities
40
Cost
77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1003033119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029011119",
            "telephone_number": "401-330-1405",
            "fax_number": "401-277-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KETTLE POINT AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029145375",
            "telephone_number": "401-330-1405",
            "fax_number": "401-277-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENHORN",
        "first_name": "BRAD",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NM",
            "license": "2012-0546",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "RI",
            "license": "MD13206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSHEALTH",
            "identifier": "110087299A",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BB81009",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.