Individual provider Active NPI

Stella M Blais, PA

  • Physician Assistant
  • Ellicott City, MD
National Provider Identifier
1114266954
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C05690 Issued in MD
Practice address
10120 Baltimore National Pike
Ellicott City, MD 21042-3614
Phone
(410) 730-3399
NPI assigned
Feb 13, 2013
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX
Physician Assistant 363A00000X VA
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X C05690 MD Primary

Addresses

Primary practice location

10120 Baltimore National Pike
Ellicott City, MD 21042-3614

Mailing address

6230 Old Dobbin LN Ste 230
Columbia, MD 21045-5884
Phone (410) 730-3399

Other practice location 1

4230 Seminary Rd
Alexandria, VA 22304
Phone (850) 559-1621

Other names 1

  • Stella Meusch Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150820010898 DC Practitioner - Physician Assistant 6608011218
I20181024002781 MD Practitioner - Physician Assistant 6608011218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Call Medical Center LLCGroup PAC ID 5496091290, 28 clinicians

Practice addresses (Care Compare)

10120 Baltimore National Pike
Ellicott City, MD 21042-3614
Phone (410) 694-7999

10981 Johns Hopkins Rd
Laurel, MD 20723-6002
Phone (410) 694-7999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C05690MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Medical Group, PA Current Accepting new patients
Centennial Medical Group, PA CurrentSince Sep 5, 2018 Accepting new patients
First Call Medical Center LLC Current Accepting new patients

Locations

6230 Old Dobbin Ln
Ste 230
Columbia, MD 21045
Phone (443) 312-2111

8186 Lark Brown Rd
Ste 201
Elkridge, MD 21075
Phone (410) 834-8110

10120 Baltimore National Pike
Ellicott City, MD 21042
Phone (410) 694-7999

10981 Johns Hopkins Rd
Laurel, MD 20723
Phone (410) 694-7999

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": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1114266954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 OLD DOBBIN LN STE 230",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455884",
            "telephone_number": "410-730-3399",
            "fax_number": "410-740-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10120 BALTIMORE NATIONAL PIKE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423614",
            "telephone_number": "410-730-3399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4230 Seminary Rd",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "22304",
            "country_code": "US",
            "telephone_number": "850-559-1621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIS",
        "first_name": "STELLA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-13",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C05690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STELLA",
            "last_name": "MEUSCH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.