Active NPI
Blaine S. Kristo, MD
- Urology Physician
- Fernandina Beach, FL
National Provider Identifier
1124128822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- ME159017
- Practice address
- 1348 S 18TH St Ste 230
Fernandina Beach, FL 32034-4785 - Phone
- (904) 277-2003
- Fax
- (904) 376-3271
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | ME159017 | FL | Primary |
| Urology Physician | 208800000X | MD-13190 | HI |
Addresses
Primary practice location
1348 S 18TH St Ste 230
Fernandina Beach, FL 32034-4785
Mailing address
PO Box 746643
Atlanta, GA 30374-6643
Phone (904) 202-2092
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 572702-01 | Medicaid | HI | |
| 0000253955 | Other | HI | HMSA BILLING NUMBER |
| 118728900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- University of Chicago, Pritzker School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1348 S 18TH St
Suite 230
Fernandina Beach, FL 32034-4785
Phone (904) 277-2003
Hospital & facility affiliations
- Accentcare Home Health of Jacksonville
- Baptist Medical Center - Nassau
- Baptist Health Medical Center - Jacksonville
- Baptist Medical Center Beaches
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.09 of 100
- Quality
- 73.82
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.82
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 32 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME159017 | FL | MD | Urology Physician |
| MD-13190 | HI | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Urology, Inc. | Urology | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
1348 S 18th St
Ste 230
Fernandina Beach, FL 32034
Phone (904) 225-8200
Interoperability endpoints
- bkristo141627@baptisthealthsystemjacksonville.direct-ci.com
Organizations & group practices 2
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.
-
- Urology Physician
- Fernandina Beach, FL
- NPI 1689011710
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fernandina Beach, FL
- NPI 1518024462
-
- General Acute Care Hospital
- Jacksonville Beach, FL
- NPI 1821155912
-
- Home Health Agency
- Orange Park, FL
- NPI 1962660399
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1578620449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762214400000",
"number": "1124128822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746643",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746643",
"telephone_number": "904-202-2092",
"fax_number": "904-376-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1348 S 18TH ST STE 230",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320344785",
"telephone_number": "904-277-2003",
"fax_number": "904-376-3271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRISTO",
"first_name": "BLAINE",
"middle_name": "S.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2025-11-04",
"certification_date": "2025-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "FL",
"license": "ME159017",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "HI",
"license": "MD-13190",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "572702-01",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA BILLING NUMBER",
"identifier": "0000253955",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "118728900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fernandina Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.