Eddie Blay Jr, MD in Fort Worth, TX

Eddie Blay Jr, MD is a medicare enrolled "Surgery - Surgical Critical Care" physician in Fort Worth, Texas. His current practice location is 1325 Pennsylvania Ave Ste 690, Fort Worth, Texas. You can reach out to his office (for appointments etc.) via phone at (817) 761-7740.

Eddie Blay Jr is licensed to practice in Texas (license number V8108) 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 1174935217.

Contact Information

	Eddie Blay Jr, MD
	1325 Pennsylvania Ave Ste 690, Fort Worth, TX 76104-2133
	(817) 761-7740
	(817) 761-7742

Map and Direction

Physician's Profile

Full Name	Eddie Blay Jr
Gender	Male
Speciality	Surgery - Surgical Critical Care
Location	1325 Pennsylvania Ave Ste 690, Fort Worth, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174935217
Provider Enumeration Date: 05/23/2014
Last Update Date: 08/14/2025

Medicare PECOS Information:

PECOS PAC ID: 6406101443
Enrollment ID: I20240807000397

Medical Identifiers

Medical identifiers for Eddie Blay Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174935217	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	036170087 (Illinois)	Secondary
208600000X	Surgery	43923-20 (Wisconsin)	Secondary
208600000X	Surgery	67923 (Tennessee)	Secondary
208600000X	Surgery	V8108 (Texas)	Secondary
2086S0102X	Surgery - Surgical Critical Care	036170087 (Illinois)	Secondary
2086S0102X	Surgery - Surgical Critical Care	43923-20 (Wisconsin)	Secondary
2086S0102X	Surgery - Surgical Critical Care	2024010643 (Missouri)	Secondary
2086S0102X	Surgery - Surgical Critical Care	V8108 (Texas)	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. Eddie Blay Jr allows following entities to bill medicare on his behalf.

Entity Name	Rockford Health Physicians
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043242886 PECOS PAC ID: 2567374036 Enrollment ID: O20031103000584

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. Eddie Blay Jr 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
Eddie Blay Jr, MD 1325 Pennsylvania Ave Ste 690, Fort Worth, TX 76104-2133 Ph: (314) 251-6440	Eddie Blay Jr, MD 1325 Pennsylvania Ave Ste 690, Fort Worth, TX 76104-2133 Ph: (817) 761-7740

Reviews and Comments

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Ryan Kostka, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1500 S Main St Fl 2, Fort Worth, TX 76104 Phone: 817-702-3000 Fax: 817-927-3958
Dr. Nabeel M Shabout, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3848 N Tarrant Pkwy Ste 100, Fort Worth, TX 76244 Phone: 817-753-6917 Fax: 817-753-6921
Miss Ruth Ellen Jones, M. D. Surgery Medicare: Medicare Enrolled Practice Location: 1500 Cooper St, Fort Worth, TX 76104 Phone: 682-885-7080 Fax: 682-885-7085

Eddie Blay Jr, MD - Medicare Surgery in Fort Worth, TX