Bryan Andrew Blanck, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

253 Issued in OK

Practice address

1631 Arlington St
Ada, OK 74820-2639

Phone

(580) 559-0001

Fax

(580) 559-0002

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centric Home Health Home health agency, Durant, OK, CCN 377791
• Mercy Hospital Ada Hospital, Ada, OK, CCN 370020
• Arbuckle Memorial Hospital Authority Hospital, Sulphur, OK, CCN 371328
• Holdenville General Hospital Hospital, Holdenville, OK, CCN 371321
• Coal County General Hospital, Inc. Hospital, Coalgate, OK, CCN 371319

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bblanck@blanck.mdlogic.direct-ci.com

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.

• Valley View Foot & Ankle Center PLLC

  • Podiatric Clinic/Center
  • Ada, OK
  • NPI 1952591158

  Podiatrist

  Medicare reassignment NPD Authorized official
• Southern Plains Medical Center of Garvin County LLC

  • Emergency Medicine Physician
  • Pauls Valley, OK
  • NPI 1083280622
  Medicare reassignment NPD
• Southern Plains Medical Center of Garvin County LLC

  • Rural Acute Care Hospital
  • Pauls Valley, OK
  • NPI 1053997338
  NPD
• Mercy Hospital Ada, Inc

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1952643306
  NPD (past)

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

• Arbuckle Memorial Hospital

  • Critical Access Hospital
  • Sulphur, OK
  • NPI 1700869492
  Care Compare affiliation
• Coal County General Hospital

  • Critical Access Hospital
  • Coalgate, OK
  • NPI 1629077227
  Care Compare affiliation
• Genesis Healthcare, LLC

  • Home Health Agency
  • Durant, OK
  • NPI 1407202740
  Care Compare affiliation
• Holdenville Hospital Authority

  • Critical Access Hospital
  • Holdenville, OK
  • NPI 1265851455
  Care Compare affiliation
• Mercy Hospital Ada, Inc

  • Ambulance
  • Ada, OK
  • NPI 1831533728

  Hospital

  Care Compare affiliation
• Mercy Hospital Ada, Inc

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1952643306
  Care Compare affiliation

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1215906276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 ARLINGTON ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202639",
            "telephone_number": "580-559-0001",
            "fax_number": "580-559-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 ARLINGTON ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202639",
            "telephone_number": "580-559-0001",
            "fax_number": "580-559-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCK",
        "first_name": "BRYAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OK",
            "license": "253",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "OK",
            "license": "253",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "OK",
            "license": "253",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "253",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OK",
            "license": "253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200119690A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Biofeedback Solutions, LLC
• Rachel Renee Birchfield, PA-C
• Courtney Laine Black, CASE MANAGEMENT
• Lyndee Black, COTA/L
• Chekota Leeann Blakemore, BA
• Khrystal Blankenship, B.H.R.S.
• Haylee Makenzi Boatright
• Body Logistics
• Ethan Timothy Boles
• Samuel Douglas Bond

• Podiatrist in Ada, OK
• Providers in Ada, OK by specialty
• Podiatrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.

Verify at the official NPI Registry.