DR. TRAVIS WAYNE BLALOCK (M.D.) – MOHS-Micrographic Surgery Physician, NPI 1710195003
MOHS-Micrographic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
126 DERMATOLOGY in OK
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Provider Addresses for DR. TRAVIS WAYNE BLALOCK (M.D.)
Northeast 13th Street, Oklahoma City, Oklahoma County, Oklahoma, 73117, United States
OKLAHOMA CITY, OK 731045001
Phone:
Type: Mailing
1525 CLIFTON RD NE STE 112A
ATLANTA, GA 303224200
Phone: (404) 778-3333
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $2,030.
Total Amount is formed as General ($2,030) + Research ($0) + Ownership ($0) = $2,030.
Last reported payment date: 2023-08-25 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($2,030).
Total Amount
$2,030
General + Research + Ownership
Payments
1
Total payment records
General Amount
$2,030
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Regeneron Healthcare Solutions, Inc. | $2,030 |
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: 2015-03-19
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 |
|---|---|---|---|---|
| I20150319002133 | I | Dermatology | GA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 287 | 218 | $0 |
| 17312 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks | 144 | 98 | $0 |
| 12032 | Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm | 74 | 69 | $0 |
| 17313 | Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks | 71 | 61 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 57 | 19 | $0 |
Insurance plans in this area (ZIP 73104)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | OK | 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 21 | 21 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | CA | |
| Internal Medicine | GA | |
| Physician Assistant | FL | |
| Interventional Radiology, Diagnostic Radiology | KY | |
| Anesthesiology Assistant | GA | |
| - | CA | |
| D E R M A T O L O G Y | GA | |
| Interventional Radiology, Diagnostic Radiology | NC | |
| Physician Assistant | GA | |
| - | GA |
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