Brianna Lee Blaskey, PA-C
Individual provider Active NPI Physician Assistant · Brightwaters, NY
NPI 1053915587 · NPPES record last updated Nov 26, 2022
Key facts
- NPI
- 1053915587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 026118 (NY)
- Practice address
- 404 Potter Blvd
Brightwaters, NY 11718-1830 - Phone
- (631) 376-0055
- NPI assigned
- Nov 25, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Shore-Lij Medical PC
Practice addresses (Care Compare)
300 Community Dr
Manhasset, NY 11030-3816
300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229
330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550
350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845
400 Potter Blvd
Brightwaters, NY 11718-1830
Phone (631) 591-7400
402 Potter Blvd
Brightwaters, NY 11718-1830
Phone (631) 587-1800
404 Potter Blvd
Brightwaters, NY 11718-1830
Phone (631) 376-0055
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- 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 |
|---|---|---|---|---|
| I20210528000862 | NY | Practitioner - Physician Assistant | 8527467265 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 026118 | NY | Yes |
Addresses
Primary practice location
404 Potter Blvd
Brightwaters, NY 11718-1830
Mailing address
110 Michael Rd
Oakdale, NY 11769-1825
Phone (631) 748-5914
Other providers in Brightwaters, NY
- All Smiles Orthodontics
- Samantha Rose Amendola
- Shane Arikian
- Robert James Balzarano
- Angela Lauria Baumann
- Julia Dlhopolsky Block
- Joanne Brennan
- Bright Bay Physical Therapy P.C.
- Bright Water Medical Procedure Suite, PLLC
- Andrew Burton
All providers in Brightwaters, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2022. 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.