Active NPI
Holly Blickenstaff, PA-C
- Physician Assistant
- Brandon, FL
National Provider Identifier
1174334122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 109 Margaret St
Brandon, FL 33511-5203 - Phone
- (813) 654-2544
- NPI assigned
- Jan 17, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
109 Margaret St
Brandon, FL 33511-5203
Mailing address
109 Margaret St
Brandon, FL 33511-5203
Phone (813) 654-2544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
109 Margaret St
Brandon, FL 33511-5203
Phone (813) 654-2544
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medi Prime Care LLC | Current | Accepting new patients | |
| Francis a Caban MD PA | Current | Accepting new patients |
Locations
109 Margaret St
Brandon, FL 33511
Phone (813) 654-2544
4164 N Armenia Ave
Tampa, FL 33607
Phone (813) 489-6212
Interoperability endpoints
- thefloridapsychiatriccenter.hollyblickenstaff@160033.advancedmd-direct.com
Organizations & group practices 2
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.
-
- Primary Care Clinic/Center
- Clearwater, FL
- NPI 1861026833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760486400000",
"number": "1174334122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 MARGARET ST",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115203",
"telephone_number": "813-654-2544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 MARGARET ST",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115203",
"telephone_number": "813-654-2544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLICKENSTAFF",
"first_name": "HOLLY",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-17",
"last_updated": "2025-10-15",
"certification_date": "2025-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.