Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1255829966 Individual Practitioner Male Practitioner

Dr. Danice Blaise , MD, MBA

General Practice • Lake Wales, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Danice Blaise, MD, MBA is a certified General Practice practicing in Lake Wales, FL. With approximately 9 years of clinical experience since completing medical education in 2017, Dr. Blaise delivers high-quality medical care to the local community at 684 STATE ROAD 60 W.

Dr. Blaise accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

684 State Road 60 W

Lake Wales, FL 338534419

Telephone 8639494868
Fax 8632238549
Associated Practice Facility / Clinic
🏢 Medical Home Alliance Llc Facility NPI 1417622853

Medicare Profile & Education

Medical School

Other

Graduation Year

2017

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Lake Wales, FL

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
9 Yrs Matches City Avg
City Avg: 9.0 Yrs
State Avg: 26.1 Yrs
Regional Practice Density
6 Specialists

Practicing in Lake Wales, FL (2490 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
48.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Blaise (9 Years) 9 Yrs
Lake Wales Specialty Average (9.0 Years) 9.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
37 11 $170.66 $88.13

Medical Specialties & State Licenses

CMS Verified: 2024-12-07
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License FL ACN1418

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License NH 25173

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License MO 2019045102

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License IN CV2000213

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
115752400 (FL)

Secondary Practice Locations

571 Avenue K Se

Winter Haven, FL 338804215

Phone: 4074400708

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Natasha Fenelon , APRN

Nurse Practitioner - Family

NPI 1003426883

Advanced Practice Registered Nurse

NPI 1104321348

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

15 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 07, 2024

General Practice (License #ACN1418 in FL)

📍
Updated Practice Location October 27, 2022

Registered at 684 STATE ROAD 60 W, LAKE WALES, FL 338534419 (Tel: 8639494868)

📍
Updated Business Mailing Address October 27, 2022

Registered at 6675 WESTWOOD BLVD STE 475, ORLANDO, FL 328216027 (Tel: 4078450330)

📍
Updated Practice Location September 23, 2020

Registered at 13035 OLIVE BLVD, CREVE COEUR, MO 631416173 (Tel: 3145486550)

📍
Updated Business Mailing Address September 23, 2020

Registered at 916 OLIVE ST, SAINT LOUIS, MO 631011400 (Tel: 3144369300)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 23, 2020

Physician Assistant (License #2019045102 in MO)

📍
Updated Practice Location June 24, 2020

Registered at 916 OLIVE ST, SAINT LOUIS, MO 631011400 (Tel: 3144369300)

📍
Updated Business Mailing Address June 24, 2020

Registered at 6017 BEAVER CREEK LN, JONESBORO, AR 724049558 (Tel: 9546810068)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 24, 2020

Physician Assistant (License #CV2000213 in IN)

NPI Profile Active April 27, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 27, 2018

Registered at 225 E JACKSON AVE, JONESBORO, AR 724013119 (Tel: 8702074261)

📍
Updated Business Mailing Address April 27, 2018

Registered at 225 E JACKSON AVE, JONESBORO, AR 724013119 (Tel: 8702074261)

👤
Provider Name / Credentials Updated April 27, 2018

Recorded as DANICE BLAISE, MD,MBA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 27, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 27, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1255829966
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 27, 2018
Last Update: December 07, 2024
Sole Proprietor: Yes

Mailing Address

6675 Westwood Blvd Ste 475

Orlando, FL 328216027

Phone: 4078450330

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.