Wyndal K Blankenship, MD in Valparaiso, FL - Medicare Internal Medicine

Wyndal K Blankenship, MD is a medicare enrolled "Internal Medicine" physician in Valparaiso, Florida. His current practice location is 120 S John Sims Pkwy, Valparaiso, Florida. You can reach out to his office (for appointments etc.) via phone at (850) 678-6621.

Wyndal K Blankenship is licensed to practice in Florida (license number ME77603) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1336132570.

Contact Information

	Wyndal K Blankenship, MD
	120 S John Sims Pkwy, Valparaiso, FL 32580-1212
	(850) 678-6621
	(850) 729-0331

Map and Direction

Physician's Profile

Full Name	Wyndal K Blankenship
Gender	Male
Speciality	Internal Medicine
Location	120 S John Sims Pkwy, Valparaiso, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1336132570
Provider Enumeration Date: 08/23/2005
Last Update Date: 10/17/2014

Medicare PECOS Information:

PECOS PAC ID: 7517958960
Enrollment ID: I20040524000822

Medical Identifiers

Medical identifiers for Wyndal K Blankenship such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336132570	NPI	-	NPPES
46862	Other	FL	BC NUMBER
N1099	Other	FL	EDI SENDER NUMBER
256934500	Medicaid	FL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	ME77603 (Florida)	Primary

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. Wyndal K Blankenship allows following entities to bill medicare on his behalf.

Entity Name	Bridgeway Health Clinics, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366000432 PECOS PAC ID: 6204263403 Enrollment ID: O20200228000718

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. Wyndal K Blankenship 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
Wyndal K Blankenship, MD 120 S John Sims Pkwy, Valparaiso, FL 32580-1212 Ph: (850) 678-6621	Wyndal K Blankenship, MD 120 S John Sims Pkwy, Valparaiso, FL 32580-1212 Ph: (850) 678-6621

Wyndal K Blankenship, MD - Medicare Internal Medicine in Valparaiso, FL