Individual provider Active NPI

Amy Blackmon, MD

  • Internal Medicine Physician
  • Redlands, CA
National Provider Identifier
1134549884
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A144585 Issued in CA
Practice address
1600 E Citrus Ave
Redlands, CA 92374-4270
Phone
(909) 794-3682
NPI assigned
Apr 21, 2014
Last updated
Dec 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A144585 CA Primary

Addresses

Primary practice location

1600 E Citrus Ave
Redlands, CA 92374-4270

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20171116001107 CA Practitioner - Internal Medicine 9234495714 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Geffen School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

1600 E Citrus Ave
Suite a
Redlands, CA 92374-4802
Phone (909) 294-3682

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A144585CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cassidy Medical Group Inc. Current Accepting new patients
Beaver Medical Group P C CurrentSince Oct 13, 2017 Accepting new patients
Centers for Family Medicine GP Internal Medicine Current Accepting new patients
Beaver Medical Group P C Internal Medicine CurrentSince Oct 13, 2017 Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine CurrentSince Jan 1, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Redlands Community Hospital Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

11600 Indian Hills Rd
Mission Hills, CA 91345
Phone (818) 781-7097

1600 E Citrus Ave
Ste A
Redlands, CA 92374
Phone (909) 294-3682

1615 Orange Tree Ln
Redlands, CA 92374
Phone (909) 335-4102

2 W Fern Ave
Redlands, CA 92373
Phone (909) 786-0725

2 W Fern Ave
#1112
Redlands, CA 92373

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

145 Thunder Dr
#1182
Vista, CA 92083
Phone (760) 941-9002

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ablackmon11063@epiclp.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1134549884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E CITRUS AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744270",
            "telephone_number": "909-794-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "AMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A144585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.