Individual provider Active NPI

Phillip Blotevogel

  • Surgery Physician
  • Paducah, KY
National Provider Identifier
1346701109
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
59247 Issued in KY
Practice address
2601 Kentucky Ave Ste 201
Paducah, KY 42003-3825
Phone
(270) 538-9555
Fax
(270) 538-9554
NPI assigned
Mar 26, 2019
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 59247 KY Primary

Addresses

Primary practice location

2601 Kentucky Ave Ste 201
Paducah, KY 42003-3825

Mailing address

2601 Kentucky Ave Ste 201
Paducah, KY 42003-3825
Phone (270) 538-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240809002319 KY Practitioner - General Surgery 6507191343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Oklahoma College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2601 Kentucky Ave
Suite 201
Paducah, KY 42003-3825
Phone (270) 538-9555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2024 Accepting new patients
Baptist Health Medical Group Inc Surgery Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2024 Accepting new patients
Baptist Healthcare System, Inc Past Accepting new patients

Locations

2601 Kentucky Ave
Ste 201
Paducah, KY 42003
Phone (270) 538-9555

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

Organizations & group practices 4

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

Hospital & facility affiliations 1

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1346701109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 KENTUCKY AVE STE 201",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033825",
            "telephone_number": "270-538-9555",
            "fax_number": "270-538-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 KENTUCKY AVE STE 201",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033825",
            "telephone_number": "270-538-9555",
            "fax_number": "270-538-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOTEVOGEL",
        "first_name": "PHILLIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "59247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.