diff --git a/pandas/core/internals/blocks.py b/pandas/core/internals/blocks.py
index 5eb59f2eb9a67..6cae99fbc656e 100644
--- a/pandas/core/internals/blocks.py
+++ b/pandas/core/internals/blocks.py
@@ -1019,7 +1019,7 @@ def putmask(self, mask, new) -> list[Block]:
                     res_blocks.extend(rbs)
                 return res_blocks
 
-    def where(self, other, cond) -> list[Block]:
+    def where(self, other, cond, _downcast="infer") -> list[Block]:
         """
         evaluate the block; return result block(s) from the result
 
@@ -1027,6 +1027,8 @@ def where(self, other, cond) -> list[Block]:
         ----------
         other : a ndarray/object
         cond : np.ndarray[bool], SparseArray[bool], or BooleanArray
+        _downcast : str or None, default "infer"
+            Private because we only specify it when calling from fillna.
 
         Returns
         -------
@@ -1066,7 +1068,7 @@ def where(self, other, cond) -> list[Block]:
 
                 block = self.coerce_to_target_dtype(other)
                 blocks = block.where(orig_other, cond)
-                return self._maybe_downcast(blocks, "infer")
+                return self._maybe_downcast(blocks, downcast=_downcast)
 
             else:
                 # since _maybe_downcast would split blocks anyway, we
@@ -1083,7 +1085,7 @@ def where(self, other, cond) -> list[Block]:
                         oth = other[:, i : i + 1]
 
                     submask = cond[:, i : i + 1]
-                    rbs = nb.where(oth, submask)
+                    rbs = nb.where(oth, submask, _downcast=_downcast)
                     res_blocks.extend(rbs)
                 return res_blocks
 
@@ -1158,21 +1160,19 @@ def fillna(
         if limit is not None:
             mask[mask.cumsum(self.ndim - 1) > limit] = False
 
-        if self._can_hold_element(value):
-            nb = self if inplace else self.copy()
-            putmask_inplace(nb.values, mask, value)
-            return nb._maybe_downcast([nb], downcast)
-
-        elif self.ndim == 1 or self.shape[0] == 1:
-            blk = self.coerce_to_target_dtype(value)
-            # bc we have already cast, inplace=True may avoid an extra copy
-            return blk.fillna(value, limit=limit, inplace=True, downcast=None)
-
+        if inplace:
+            nbs = self.putmask(mask.T, value)
         else:
-            # operate column-by-column
-            return self.split_and_operate(
-                type(self).fillna, value, limit=limit, inplace=inplace, downcast=None
-            )
+            # without _downcast, we would break
+            #  test_fillna_dtype_conversion_equiv_replace
+            nbs = self.where(value, ~mask.T, _downcast=False)
+
+        # Note: blk._maybe_downcast vs self._maybe_downcast(nbs)
+        #  makes a difference bc blk may have object dtype, which has
+        #  different behavior in _maybe_downcast.
+        return extend_blocks(
+            [blk._maybe_downcast([blk], downcast=downcast) for blk in nbs]
+        )
 
     def interpolate(
         self,
@@ -1401,7 +1401,8 @@ def setitem(self, indexer, value):
         else:
             return self
 
-    def where(self, other, cond) -> list[Block]:
+    def where(self, other, cond, _downcast="infer") -> list[Block]:
+        # _downcast private bc we only specify it when calling from fillna
         arr = self.values.T
 
         cond = extract_bool_array(cond)
@@ -1429,7 +1430,7 @@ def where(self, other, cond) -> list[Block]:
                 # TestSetitemFloatIntervalWithIntIntervalValues
                 blk = self.coerce_to_target_dtype(orig_other)
                 nbs = blk.where(orig_other, orig_cond)
-                return self._maybe_downcast(nbs, "infer")
+                return self._maybe_downcast(nbs, downcast=_downcast)
 
             elif isinstance(self, NDArrayBackedExtensionBlock):
                 # NB: not (yet) the same as
@@ -1485,39 +1486,29 @@ def fillna(
     ) -> list[Block]:
         # Caller is responsible for validating limit; if int it is strictly positive
 
-        try:
-            new_values = self.values.fillna(value=value, limit=limit)
-        except (TypeError, ValueError) as err:
-            _catch_deprecated_value_error(err)
-
-            if is_interval_dtype(self.dtype):
-                # Discussion about what we want to support in the general
-                #  case GH#39584
-                blk = self.coerce_to_target_dtype(value)
-                return blk.fillna(value, limit, inplace, downcast)
-
-            elif isinstance(self, NDArrayBackedExtensionBlock):
-                # We support filling a DatetimeTZ with a `value` whose timezone
-                #  is different by coercing to object.
-                if self.dtype.kind == "m":
-                    # GH#45746
-                    warnings.warn(
-                        "The behavior of fillna with timedelta64[ns] dtype and "
-                        f"an incompatible value ({type(value)}) is deprecated. "
-                        "In a future version, this will cast to a common dtype "
-                        "(usually object) instead of raising, matching the "
-                        "behavior of other dtypes.",
-                        FutureWarning,
-                        stacklevel=find_stack_level(),
-                    )
-                    raise
-                blk = self.coerce_to_target_dtype(value)
-                return blk.fillna(value, limit, inplace, downcast)
-
-            else:
+        if self.dtype.kind == "m":
+            try:
+                res_values = self.values.fillna(value, limit=limit)
+            except (ValueError, TypeError):
+                # GH#45746
+                warnings.warn(
+                    "The behavior of fillna with timedelta64[ns] dtype and "
+                    f"an incompatible value ({type(value)}) is deprecated. "
+                    "In a future version, this will cast to a common dtype "
+                    "(usually object) instead of raising, matching the "
+                    "behavior of other dtypes.",
+                    FutureWarning,
+                    stacklevel=find_stack_level(),
+                )
                 raise
+            else:
+                res_blk = self.make_block(res_values)
+                return [res_blk]
 
-        return [self.make_block_same_class(values=new_values)]
+        # TODO: since this now dispatches to super, which in turn dispatches
+        #  to putmask, it may *actually* respect 'inplace=True'. If so, add
+        #  tests for this.
+        return super().fillna(value, limit=limit, inplace=inplace, downcast=downcast)
 
     def delete(self, loc) -> Block:
         # This will be unnecessary if/when __array_function__ is implemented