Blake Bailey Anderson, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

35133214 Issued in OH

Practice address

2350 Miami Valley Dr Ste 500
Centerville, OH 45459-4780

Phone

(937) 293-1622

Fax

(937) 245-6308

NPI assigned

Jul 1, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Urology

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dayton Physicians LLCGroup PAC ID 1456374859, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
• Upper Valley Medical Center Hospital, Troy, OH, CCN 360174
• Atrium Medical Center Hospital, Franklin, OH, CCN 360076

Merit-based Incentive Payment System (MIPS)

Final score

93.37 of 100Reported as individual

Quality

85.47

Promoting interoperability

100

Improvement activities

40

Cost

92.42

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dayton Physicians, LLC

  • Hematology & Oncology Physician
  • Dayton, OH
  • NPI 1902844947

  Urology

  Medicare reassignment Care Compare group NPD
• Dayton Physicians, LLC

  • Durable Medical Equipment & Medical Supplies
  • Dayton, OH
  • NPI 1811141559

  Urology

  NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

• Atrium Medical Center

  • General Acute Care Hospital
  • Franklin, OH
  • NPI 1700950060
  Care Compare affiliation
• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation
• Upper Valley Medical Center

  • General Acute Care Hospital
  • Troy, OH
  • NPI 1184638942
  Care Compare affiliation

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1760779458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6680 POE AVE STE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454142855",
            "telephone_number": "937-280-8400",
            "fax_number": "937-245-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 MIAMI VALLEY DR STE 500",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594780",
            "telephone_number": "937-293-1622",
            "fax_number": "937-245-6308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 N Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "454151165",
            "country_code": "US",
            "telephone_number": "937-293-1622",
            "fax_number": "937-245-6308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BLAKE",
        "middle_name": "BAILEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125.059643",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01078386A",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35133214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0292533",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "banderson1489435@direct.premierhealth.com",
            "affiliation": "N",
            "address_1": "2350 Miami Valley Dr Ste 500",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454594780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Manuel Alvarez Jr., PA-C
• Anthony C Amagwu, CNP
• Shivani Ambani
• Ambulatory Neurological Services, LLC
• Anansi, LLC
• Kristy Ellen Anderson, M.D.
• Lindsay Renee Anderson, BS, BC-HIS
• Richard Warren Anderson
• Anesthesiology Services Network
• Coca Anghelache, CNP

• Urology Physician in Centerville, OH
• Providers in Centerville, OH by specialty
• Urology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.