Michael Blythe, PA-C
Individual provider Active NPI Physician Assistant · Elko, NV
NPI 1013346410 · NPPES record last updated Mar 14, 2024
Key facts
- NPI
- 1013346410
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA1983 (NV)
- Practice address
- 2102 Idaho St
Elko, NV 89801 - Phone
- (775) 389-5777
- Fax
- (775) 360-3602
- NPI assigned
- Nov 6, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health Allied Medical Providers - Pappas PLLC
First Choice Physical Therapy
Practice addresses (Care Compare)
2102 Idaho St
Elko, NV 89801-2625
Phone (775) 389-5777
248 Country Club Pkwy
Spring Creek, NV 89815-5830
Phone (775) 777-1276
Hospital & facility affiliations
- Northeastern Nevada Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180719001751 | NV | Practitioner - Physician Assistant | 7618105347 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8797967-1206 | UT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Choice Physical Therapy | Current |
Accepting new patients | |
| Communityhealth Management, LLC | Past | Accepting new patients | |
| First Choice Physical Therapy, Inc | Past |
Accepting new patients | |
| Tucker Medical Group, P.C. | Past | Accepting new patients |
Locations
248 Country Club Pkwy
Spring Creek, NV 89815
Phone (775) 254-8587
Interoperability endpoints
- mblythe@direct.nevadahealthcenters.nextgenshare.com
- michael.blythe.p1@direct.elkochc.nextgenshare.com
- https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 8797967-1206 | UT | |
| Physician Assistant | 363A00000X | 8797967-8906 | UT | |
| Physician Assistant | 363A00000X | PA1983 | NV | Yes |
Addresses
Primary practice location
2102 Idaho St
Elko, NV 89801
Mailing address
2102 Idaho St
Elko, NV 89801-7913
Phone (775) 389-5777
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013346410 | Medicaid | NV |
Other providers in Elko, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.