Individual provider Active NPI

Michael W Blaney, MD

  • Surgery Physician
  • Martinez, GA
National Provider Identifier
1992881122
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
40614 Issued in GA
Practice address
3830 Washington Rd Ste 17
Martinez, GA 30907-5080
Phone
(706) 922-0440
Fax
(706) 922-0441
NPI assigned
Oct 31, 2006
Last updated
Jun 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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 40614 GA Primary

Addresses

Primary practice location

3830 Washington Rd Ste 17
Martinez, GA 30907-5080

Mailing address

2101 Central Avenue
Augusta, GA 30904
Phone (706) 738-3359

Other practice location 1

2101 Central Avenue
Augusta, GA 30904
Phone (706) 738-3359

Other practice location 2

100 Hillcrest Pkwy
Dublin, GA 31021
Phone (706) 922-0440

Other identifiers 2

IdentifierTypeStateIssuer
G40614MedicaidSC
000906727CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20101215000928 GA Practitioner - General Surgery 7618985110 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Emory University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Augusta Primary Care Services LLCGroup PAC ID 2466513874, 37 clinicians

Practice addresses (Care Compare)

3830 Washington Rd
Suite 17
Martinez, GA 30907-5080
Phone (706) 992-0440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux35
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40614GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dublin Multispecialty LLC CurrentSince Feb 18, 2025 Accepting new patients
Augusta Primary Care Services LLC CurrentSince Sep 1, 2020 Accepting new patients
Fairview Park, Limited Partnership Past Accepting new patients
Doctors Hospital of Augusta LLC Past Accepting new patients

Locations

3623 J Dewey Gray Cir
Ste 210
Augusta, GA 30909
Phone (706) 651-5780

100 Hillcrest Pkwy
Dublin, GA 31021
Phone (706) 922-0440

200 Fairview Park Dr
Dublin, GA 31021
Phone (478) 272-6150

200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865

3830 Washington Rd
Ste 17
Martinez, GA 30907
Phone (706) 364-5228

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: michael.blaney@hca5.eclinicaldirectplus.com

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 3

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1992881122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CENTRAL AVENUE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30904",
            "telephone_number": "706-738-3359",
            "fax_number": "706-738-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 WASHINGTON RD STE 17",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309075080",
            "telephone_number": "706-922-0440",
            "fax_number": "706-922-0441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Central Avenue",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "30904",
            "country_code": "US",
            "telephone_number": "706-738-3359",
            "fax_number": "706-738-0565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Hillcrest Pkwy",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "GA",
            "postal_code": "31021",
            "country_code": "US",
            "telephone_number": "706-922-0440",
            "fax_number": "706-922-0441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANEY",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "40614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G40614",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000906727C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, GA

Sources for this page

Verify at the official NPI Registry.