Dr Danice Blaise, MD,MBA is a medicare enrolled "General Practice" physician in Lake Wales, Florida. He graduated from medical school in 2017 and has 8 years of diverse experience with area of expertise as General Practice. His current practice location is
684 State Road 60 W, Lake Wales, Florida. You can reach out to his office (for appointments etc.) via phone at
(863) 949-4868.
Dr Danice Blaise is licensed to practice in Florida (license number ACN1418) 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 1255829966.
Physician's Profile
| Full Name | Dr Danice Blaise |
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| Gender | Male |
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| Speciality | General Practice |
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| Experience | 8 Years |
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| Location | 684 State Road 60 W, Lake Wales, Florida |
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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:
- Dr Danice Blaise graduated from medical school in 2017
NPI Data:
- NPI Number: 1255829966
- Provider Enumeration Date: 04/27/2018
- Last Update Date: 12/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 1355738899
- Enrollment ID: I20220502000035
Medical Identifiers
Medical identifiers for Dr Danice Blaise such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1255829966 | NPI | - | NPPES |
| 115752400 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | ACN1418 (Florida) | Primary |
| 207R00000X | Internal Medicine | 25173 (New Hampshire) | Secondary |
| 363A00000X | Physician Assistant | 2019045102 (Missouri) | Secondary |
| 363A00000X | Physician Assistant | CV2000213 (Indiana) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
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. Dr Danice Blaise allows following entities to bill medicare on his behalf.
| Entity Name | The Center For Functional Aesthetic And Anti Aging Medicine Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508682089
PECOS PAC ID: 5496277212
Enrollment ID: O20250320002306 |
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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. Dr Danice Blaise 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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Dr Danice Blaise, MD,MBA
6675 Westwood Blvd Ste 475,
Orlando, FL 32821-6027
Ph: (407) 845-0330 | Dr Danice Blaise, MD,MBA
684 State Road 60 W,
Lake Wales, FL 33853-4419
Ph: (863) 949-4868 |
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