BLAYNE DAVID BAGGETT – Physician Assistant, NPI 1114382637

BLAYNE DAVID BAGGETT is a healthcare provider. based in Fenton, Michigan. specializing in PHYSICIAN ASSISTANT. They hold a License No. 5601007628 (MI). The NPI Number for BLAYNE DAVID BAGGETT is 1114382637

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
BLAYNE DAVID BAGGETT
NPI
1114382637
Phone
(810) 629-9200
Address
305 N LEROY ST
Enumeration Date
29 December 2015
Last Update Date
29 December 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5863141400
Graduation Year
2015 (11 years ago)
PAC ID
5991007833
Group Practice PAC ID
6800806050
Professional Enrollment ID
I20160108000751
Address ID
MI483141357ST44056RDXX303
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

Provider Addresses for BLAYNE DAVID BAGGETT

  • 305 N LEROY ST

    FENTON, MI 484302729

    Phone: (810) 629-9200

    Fax: (810) 629-9653

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 119 Open Payments records for all available years, with a total value of $2,169.

Total Amount is formed as General ($2,169) + Research ($0) + Ownership ($0) = $2,169.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: ABBVIE INC. ($516).

Total Amount

$2,169

General + Research + Ownership

Payments

119

Total payment records

General Amount

$2,169

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2016-01-08

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160108000751IPhysician AssistantMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths47547$0
99213Established patient office or other outpatient visit, 20-29 minutes15294$0
17000Destruction of precancer skin growth, 1 growth11451$0
17110Destruction of skin growth, 1-14 growths9047$0
99214Established patient office or other outpatient visit, 30-39 minutes5749$0
View full utilization report →

Insurance plans in this area (ZIP 48430)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800806050View full group profile
NameSpecialtyState
Nurse PractitionerMI
Physician AssistantMI
-MI
-MI
-MI
D E R M A T O L O G YMI
Physician AssistantMI

Reviews

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Frequently asked questions

How do payers reference BLAYNE DAVID BAGGETT?
For BLAYNE DAVID BAGGETT, use NPI 1114382637 as the unique 10-digit identifier.
Is BLAYNE DAVID BAGGETT still an active registrant?
BLAYNE DAVID BAGGETT carries an active NPI according to the public dataset.
What area of care is associated with BLAYNE DAVID BAGGETT?
BLAYNE DAVID BAGGETT's record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for BLAYNE DAVID BAGGETT?
Travel planning: use Fenton, Michigan as the reference point for BLAYNE DAVID BAGGETT, then confirm.
When was this NPI issued?
Enumeration for BLAYNE DAVID BAGGETT is noted as December 29, 2015 where the registry provides it.

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