Active NPI
Eddie Blay Jr., M.D
- Surgical Critical Care Physician
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Critical Care Physician
- License
- V8108
- Practice address
- 1325 Pennsylvania Ave Ste 690
Fort Worth, TX 76104-2133 - Phone
- (817) 761-7740
- Fax
- (817) 761-7742
- NPI assigned
- May 23, 2014
- 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 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036170087 | IL | |
| Surgery Physician | 208600000X | 43923-20 | WI | |
| Surgery Physician | 208600000X | 67923 | TN | |
| Surgery Physician | 208600000X | V8108 | TX | |
| Surgical Critical Care Physician | 2086S0102X | 036170087 | IL | |
| Surgical Critical Care Physician | 2086S0102X | 43923-20 | WI | |
| Surgical Critical Care Physician | 2086S0102X | 2024010643 | MO | |
| Surgical Critical Care Physician | 2086S0102X | V8108 | TX | Primary |
Addresses
Primary practice location
1325 Pennsylvania Ave Ste 690
Fort Worth, TX 76104-2133
Mailing address
1325 Pennsylvania Ave Ste 690
Fort Worth, TX 76104-2133
Phone (314) 251-6440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, WI, MO, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Duke University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000
1325 Pennsylvania Ave
Suite 690
Fort Worth, TX 76104-2133
Phone (817) 250-7030
Hospital & facility affiliations
- Texas Health Harris Methodist Fort Worth
- Mercy Health System Corp
- Mercy Hospital St Louis
- Texas Health Harris Methodist Hospital Azle
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036170087 | IL | MD | Surgery Physician |
| V8108 | TX | MD | Surgery Physician |
| 43923-20 | WI | MD | Surgical Critical Care Physician |
| 67923 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Health Physicians Group | Current | Accepting new patients | |
| Mercy Clinic Trauma and General Surgery, LLC | Current | Accepting new patients | |
| Rockford Health Physicians | Current | Accepting new patients | |
| Texas Health Physicians Group | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Clinic Surgical Specialists, LLC | Surgery | Current | Accepting new patients |
| Texas Health Physicians Group | Current | Accepting new patients | |
| Mercy Clinic East Communities | Past | Accepting new patients | |
| Mercy Hospitals East Communities | Past | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310
8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
10012 Kennerly Rd
Ste 406
Saint Louis, MO 63128
Phone (314) 525-1224
621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070
621 S New Ballas Rd
Ste 560A
Saint Louis, MO 63141
Phone (314) 251-6440
1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803
800 5th Ave
Ste 400
Fort Worth, TX 76104
Phone (817) 702-9100
1325 Pennsylvania Ave
Ste 690
Fort Worth, TX 76104
Phone (817) 761-7740
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
Organizations & group practices 10
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.
-
- Internal Medicine Physician
- Fort Worth, TX
- NPI 1174573596
-
- Multi-Specialty Clinic/Center
- Janesville, WI
- NPI 1598718603
-
- Vascular Surgery Physician
- Washington, MO
- NPI 1043530538
-
- Trauma Surgery Physician
- Saint Louis, MO
- NPI 1699825695
-
- Multi-Specialty Clinic/Center
- Rockford, IL
- NPI 1043242886
-
- Sleep Disorder Diagnostic Clinic/Center
- Fort Worth, TX
- NPI 1114395969
-
- Sleep Disorder Diagnostic Clinic/Center
- Dallas, TX
- NPI 1174992051
-
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1851335228
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Azle, TX
- NPI 1508899204
-
- General Acute Care Hospital
- Fort Worth, TX
- NPI 1336172105
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755129600000",
"number": "1174935217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 PENNSYLVANIA AVE STE 690",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042133",
"telephone_number": "314-251-6440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 PENNSYLVANIA AVE STE 690",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042133",
"telephone_number": "817-761-7740",
"fax_number": "817-761-7742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAY",
"first_name": "EDDIE",
"name_suffix": "Jr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-23",
"last_updated": "2025-08-14",
"certification_date": "2025-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036170087",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "43923-20",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TN",
"license": "67923",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "V8108",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "IL",
"license": "036170087",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "WI",
"license": "43923-20",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "MO",
"license": "2024010643",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "TX",
"license": "V8108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.