DALE W BLAISE (MD) – Family Medicine Physician, NPI 1770557472
Family Medicine Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DALE W BLAISE (MD)
Carbondale Post Office, Main Street, Carbondale, Osage County, Kansas, 66414, United States
CARBONDALE, IL 629023988
Phone: (618) 457-5200
Type: Mailing
19 E SHAWNEE DR STE 2
MURPHYSBORO, IL 629667072
Phone: (618) 684-2172
Fax: (618) 687-4480
Type: Location
19, East Shawnee Drive, Murphysboro, Jackson County, Illinois, 62966, United States
MURPHYSBORO, IL 62966
Phone: (618) 684-2172
Fax: (618) 687-4480
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 102 Open Payments records for all available years, with a total value of $1,672.
Total Amount is formed as General ($1,672) + Research ($0) + Ownership ($0) = $1,672.
Last reported payment date: 2024-03-18 • Largest payer in this snapshot: Lilly USA, LLC ($359).
Total Amount
$1,672
General + Research + Ownership
Payments
102
Total payment records
General Amount
$1,672
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $359 |
| AstraZeneca Pharmaceuticals LP | $263 |
| ABBVIE INC. | $179 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $120 |
| Abbott Laboratories | $118 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-03-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070329000493 | I | Family Practice | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62902)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H E M A T O L O G Y/ O N C O L O G Y | IL | |
| Cardiovascular Disease (Cardiology) | IL | |
| - | IL | |
| Emergency Medicine | IL | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | IL | |
| Emergency Medicine | IL | |
| - | IL | |
| N E U R O L O G Y | IL | |
| U R O L O G Y | IL |
Reviews
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