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DR. RUSSELL R BLAKELEY M.D. NPI 1063409639


NPI Information

NPI: 1063409639
Provider Name: DR. RUSSELL R BLAKELEY, M.D.
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

Organization: KOOTENAI HEALTH

PECOS Registration: Yes

Address:
606 N THIRD AVE
SUITE 203
SANDPOINT, ID
ZIP 83864
Phone: (208) 263-8505
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DR. Russell R Blakeley, M.D. is a cardiovascular disease internal medicine in Sandpoint, ID with 42 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. DR. Russell R Blakeley, M.D. NPI is 1063409639. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduation Year:1982

The provider's business location address is:

606 N THIRD AVE
SUITE 203
SANDPOINT, ID
ZIP 83864-594
Phone: (208) 263-8505
Fax: (208) 263-2908

The NPI 1063409639 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report (HCPCS:93010)
  • Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report (HCPCS:93280)
  • Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)
  • Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report (HCPCS:93018)

The enumeration date for this NPI number is 9/29/2005 and was last updated on 1/27/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0000XInternal MedicineCardiovascular Disease16299TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13859385MEDICARE PINTENNESSEE
2103I060787MEDICARE PINTENNESSEE
3P00841514MEDICARE PIN
4D93197MEDICARE UPINTENNESSEE
53859386MEDICAIDTENNESSEE
6103I066492MEDICARE PINTENNESSEE
760068974MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.