Individual provider Active NPI

Amy A Blazek, PA

  • Physician Assistant
  • Lubbock, TX
National Provider Identifier
1174621247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3502 9TH St
Ste 110
Lubbock, TX 79415-3300
Phone
(806) 744-1171
Fax
(806) 744-1169
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3502 9TH St
Ste 110
Lubbock, TX 79415-3300

Mailing address

5219 City Bank Pkwy
Ste 35
Lubbock, TX 79407-3544
Phone (806) 785-7676

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070226000196 TX Practitioner - Physician Assistant 8729180500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lubbock County Hospital DistrictGroup PAC ID 6709028954, 49 clinicians

Practice addresses (Care Compare)

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-8200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock County Hospital District Past Accepting new patients
Lubbock County Hospital District Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amy.blazek@direct.myteamcare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174621247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 CITY BANK PKWY",
            "address_2": "STE 35",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794073544",
            "telephone_number": "806-785-7676",
            "fax_number": "806-785-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 9TH ST",
            "address_2": "STE 110",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794153300",
            "telephone_number": "806-744-1171",
            "fax_number": "806-744-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZEK",
        "first_name": "AMY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.