Dr Blake Jeffrey Illston, DO - Medicare Emergency Medicine in Fort Gordon, GA

Dr Blake Jeffrey Illston, DO is a medicare enrolled "Emergency Medicine" physician in Fort Gordon, Georgia. His current practice location is 300 W Hospital Rd, Fort Gordon, Georgia. You can reach out to his office (for appointments etc.) via phone at (706) 787-9285.

Dr Blake Jeffrey Illston is licensed to practice in Georgia (license number 68035) 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 1487876355.

Contact Information

Dr Blake Jeffrey Illston, DO
300 W Hospital Rd,
Fort Gordon, GA 30905-5741
(706) 787-9285
Not Available



Physician's Profile

Full NameDr Blake Jeffrey Illston
GenderMale
SpecialityEmergency Medicine
Location300 W Hospital Rd, Fort Gordon, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1487876355
  • Provider Enumeration Date: 05/02/2007
  • Last Update Date: 03/29/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5496806085
  • Enrollment ID: I20120711000446

Medical Identifiers

Medical identifiers for Dr Blake Jeffrey Illston such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1487876355NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207PE0004XEmergency Medicine - Emergency Medical Services RTP001882 (Georgia)Secondary
207P00000XEmergency Medicine 68035 (Georgia)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. Dr Blake Jeffrey Illston allows following entities to bill medicare on his behalf.
Entity NameAugusta Physicians Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518169168
PECOS PAC ID: 6608977251
Enrollment ID: O20070726000065

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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 Blake Jeffrey Illston 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 AddressPractice Location Address
Dr Blake Jeffrey Illston, DO
300 W Hospital Rd,
Fort Gordon, GA 30905-5741

Ph: (706) 787-9285
Dr Blake Jeffrey Illston, DO
300 W Hospital Rd,
Fort Gordon, GA 30905-5741

Ph: (706) 787-9285

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Emergency Medicine Doctors in Fort Gordon, GA

Dr. Jared Allan Sutton, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 300 Hospital Road, Emergency Department, Fort Gordon, GA 30905
Phone: 605-520-1755    
Dr. Chris K Jensen, DO
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 300 E Hospital Road, Fort Gordon, GA 30905
Phone: 706-787-5811    
William Charles Arnett, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 300 W Hospital Rd, Fort Gordon, GA 30905
Phone: 706-787-2264    
Dr. David Wilson Coffin, M.D.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 300 W Hospital Rd, Eisenhower Army Medical Center, Fort Gordon, GA 30905
Phone: 706-787-2720    Fax: 707-787-8176
Priya Venugopal, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 300 W Hospital Rd, Fort Gordon, GA 30905
Phone: 706-787-9285    
Dr. Steven James Currier, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 300 W Hospital Rd, Department Of Emergency Medicine, Fort Gordon, GA 30905
Phone: 706-787-2961    Fax: 706-787-2961
Zachary Sutton, D.O.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 300 W Hospital Rd Rm 5c-09, Fort Gordon, GA 30905
Phone: 706-787-1968    

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