Sarah Blazovic
Individual provider Active NPI Pediatrics Physician · Temple, TX
NPI 1083119945 · NPPES record last updated Apr 3, 2023
Key facts
- NPI
- 1083119945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 178930 (AK)
- Practice address
- 2401 S 31St St
Temple, TX 76508-0001 - Phone
- (254) 935-5063
- NPI assigned
- Mar 24, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250121003603 | NJ | Practitioner - Pediatric Medicine | 6204363856 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178930 | AK | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Healthcare Associates of New Jersey PC | Pediatrics | Current |
Accepting new patients |
| Childrens Health Care Associates of New Jersey PC | Pediatrics | Current | Accepting new patients |
| Childens Health Care Associates of New Jersey PC | Current |
Accepting new patients | |
| Alaska Pediatric Night Clinic, Inc. | Pediatrics | Past | Accepting new patients |
Locations
707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717
1012 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 435-0086
2929 Arch St
Fl 12
Philadelphia, PA 19104
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | PA | ||
| Pediatrics Physician | 208000000X | 178930 | AK | Yes |
Addresses
Primary practice location
2401 S 31St St
Temple, TX 76508-0001
Mailing address
751 E 36TH Ave Ste 100
Anchorage, AK 99503-4166
Phone (907) 222-5090
Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2023. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.