Mary Katherine Bleitner

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

202326272 Issued in MO

Practice address

600 High Tech Dr
Georgetown, TX 78626-8185

Phone

(512) 930-4776

NPI assigned

Nov 24, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment
• Chisholm Trail Pediatrics Inc PA

  • Primary Care Clinic/Center
  • Georgetown, TX
  • NPI 1114112745
  NPD (past)

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

{
    "created_epoch": "1700784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1104691724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SAN MARCOS ST UNIT 253",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787022664",
            "telephone_number": "314-737-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGH TECH DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786268185",
            "telephone_number": "512-930-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEITNER",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-24",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "202326272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blackbird Enterprises, LLC (Allegiance Ambulance)
• Erika Blair, M.A., LPC, RPT
• Deborah L Bland, LCSW
• Calli Rae Blaschke
• Alexandra Knudson Bleasdell, FNP-C
• Blessed Family Chiropractic, PLLC
• Blessed Family Wellness
• Blink Boutique Eyecare & Eyewear PLLC
• Karen Sutliff Block
• Bloombridge Speech Service PLLC

• Pediatric Nurse Practitioner in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.