Individual provider Active NPI

Eddie Blay Jr., M.D

  • Surgical Critical Care Physician
  • Fort Worth, TX
National Provider Identifier
1174935217
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
V8108 Issued in TX
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

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
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, TX4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20240807000397 IL Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 6406101443 Reassigns benefits to 1 organization
I20240807000794 WI Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 6406101443 Reassigns benefits to 1 organization
I20240912003471 MO Practitioner - General Surgery 6406101443 Reassigns benefits to 2 organizations
I20250725002161 TX Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 6406101443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Duke University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

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 Hospital, Fort Worth, TX, CCN 450135
  • Mercy Health System Corp Hospital, Janesville, WI, CCN 520066
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Texas Health Harris Methodist Hospital Azle Hospital, Azle, TX, CCN 450419

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036170087ILMDSurgery Physician
V8108TXMDSurgery Physician
43923-20WIMDSurgical Critical Care Physician
67923TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Aug 1, 2025 Accepting new patients
Mercy Clinic Trauma and General Surgery, LLC CurrentSince Sep 9, 2024 Accepting new patients
Rockford Health Physicians CurrentSince Jul 24, 2024 Accepting new patients
Texas Health Physicians Group CurrentSince Aug 1, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Jul 24, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Jul 24, 2024 Accepting new patients
Mercy Clinic Surgical Specialists, LLC Surgery CurrentSince Nov 21, 2024 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.

Hospital & facility affiliations 5

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

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

Verify at the official NPI Registry.