NPIMap

Individual provider Active NPI

William James Blanke, MD

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1720048754
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01054117A Issued in IN
Practice address
801 Saint Marys Dr Ste 505E
Evansville, IN 47714-0528
Phone
(812) 491-3236
NPI assigned
Mar 24, 2006
Last updated
May 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01054117A IN Primary

Addresses

Primary practice location

801 Saint Marys Dr Ste 505E
Evansville, IN 47714-0528

Mailing address

801 Saint Marys Dr Ste 505E
Evansville, IN 47714-0528

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address william.blanke.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040804000131 IN Practitioner - Family Practice 8527039460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Easter Seals Rehabilitation Center IncGroup PAC ID 8426135179, shared by 3 NPIs, 41 clinicians
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

3701 Bellemeade Ave
Evansville, IN 47714-0137
Phone (812) 479-1411

801 Saint Marys Dr
505E
Evansville, IN 47714-0528
Phone (812) 491-3236

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01054117AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Medical Group, LLC Family Medicine CurrentSince Feb 25, 2014 Accepting new patients
Primary Physicians Network LLC Family Medicine Current Accepting new patients
St Mary's Medical Group, LLC CurrentSince Feb 25, 2014 Accepting new patients
Major Hospital Past Accepting new patients
St. Mary's Health, Inc Family Medicine Past Accepting new patients

Locations

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

3900 Washington Ave
#200
Evansville, IN 47714
Phone (812) 485-4144

6221 Physicians Ct
Evansville, IN 47715
Phone (812) 491-3236

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

7240 S US Highway 231
Huntingburg, IN 47542
Phone (812) 683-6336

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

Interoperability endpoints

  • Direct secure messaging: william.blanke.1@7598.direct.athenahealth.com

Organizations & group practices 5

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 6

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1720048754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SAINT MARYS DR STE 505E",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SAINT MARYS DR STE 505E",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140528",
            "telephone_number": "812-491-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKE",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01054117A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "william.blanke.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "801 Saint Marys Dr Ste 505E",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.