Individual provider Active NPI

Ann Blakley, MD

  • Pediatrics Physician
  • Galveston, TX
National Provider Identifier
1023063831
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N8017 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-4979
Phone
(409) 772-3695
Fax
(832) 340-2350
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N8017 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-4979

Mailing address

PO Box 650859
Dept 710
Dallas, TX 75265
Phone (409) 747-6240

Other identifiers 4

IdentifierTypeStateIssuer
9150513OtherTXCIGNA
7867011OtherTXAETNA
8CW743OtherTXBCBS
286529701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111122000869 TX Practitioner - Pediatric Medicine 2062491657 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N8017TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice Pediatrics CurrentSince Mar 11, 2013 Accepting new patients
Texas Gulf Coast Medical System, Inc Pediatrics Past Accepting new patients
University of Texas Medical Branch at Galveston Past Accepting new patients

Locations

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

6416 Broadway St
Galveston, TX 77551
Phone (409) 744-5437

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

2027 61st St
Galveston, TX 77551
Phone (409) 744-9800

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

2785 Gulf Fwy S
League City, TX 77573
Phone (409) 772-3695

2240 Gulf Fwy S
League City, TX 77573
Phone (832) 505-1000

3023 Marina Bay Dr
Ste 101
League City, TX 77573
Phone (281) 334-0620

250 Blossom St
Ste 300
Webster, TX 77598

17448 Highway 3
Ste 200
Webster, TX 77598
Phone (832) 505-1748

Interoperability endpoints

  • Direct secure messaging: ablakleymd43144@direct.utmb.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1023063831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650859",
            "address_2": "DEPT 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75265",
            "telephone_number": "409-747-6240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775554979",
            "telephone_number": "409-772-3695",
            "fax_number": "832-340-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKLEY",
        "first_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N8017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9150513",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7867011",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CW743",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286529701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.