Blake Olmsted, MD is a medicare enrolled "Allergy & Immunology" physician in Hattiesburg, Mississippi. He went to University Of Mississippi School Of Medicine and graduated in 2012 and has 12 years of diverse experience with area of expertise as Allergy/immunology. He is a member of the group practice Hattiesburg Clinic, Pa and his current practice location is
6414 U S Highway 98 Ste 80, Hattiesburg, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 261-1800.
Blake Olmsted is licensed to practice in Mississippi (license number 23912) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1780948216.
Physician's Profile
| Full Name | Blake Olmsted |
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| Gender | Male |
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| Speciality | Allergy/immunology |
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| Experience | 12 Years |
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| Location | 6414 U S Highway 98 Ste 80, Hattiesburg, Mississippi |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Blake Olmsted attended and graduated from University Of Mississippi School Of Medicine in 2012
NPI Data:
- NPI Number: 1780948216
- Provider Enumeration Date: 06/29/2012
- Last Update Date: 08/11/2020
Medicare PECOS Information:
- PECOS PAC ID: 2769604578
- Enrollment ID: I20170803001050
Medical Identifiers
Medical identifiers for Blake Olmsted such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780948216 | NPI | - | NPPES |
| 05583609 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207K00000X | Allergy & Immunology | 23912 (Mississippi) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Hattiesburg Clinic, Pa | 5193706794 | 488 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Blake Olmsted allows following entities to bill medicare on his behalf.
| Entity Name | Hattiesburg Clinic Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1740213446
PECOS PAC ID: 5193706794
Enrollment ID: O20040528000685 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blake Olmsted is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Blake Olmsted, MD
415 S 28th Ave,
Hattiesburg, MS 39401-7246
Ph: (601) 579-5463 | Blake Olmsted, MD
6414 U S Highway 98 Ste 80,
Hattiesburg, MS 39402-7838
Ph: (601) 261-1800 |
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