NPIMap

Individual provider Active NPI

Raya Blackwell

  • Medical Physician Assistant
  • Lake Mary, FL
National Provider Identifier
1194414292
Registry record updated May 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
755 Rinehart Rd Ste 100
Lake Mary, FL 32746-4885
Phone
(407) 320-8100
NPI assigned
May 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

755 Rinehart Rd Ste 100
Lake Mary, FL 32746-4885

Mailing address

755 Rinehart Rd Ste 100
Lake Mary, FL 32746-4885
Phone (407) 320-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231003003587 FL Practitioner - Physician Assistant 6002260445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Volusia Family and Sports Medicine IncGroup PAC ID 1456483098, 11 clinicians

Practice addresses (Care Compare)

1590 S Sr
15A Suite 100
Deland, FL 32720-7817
Phone (386) 774-0016

1590 S State Rd
15A 100
Deland, FL 32720-7817
Phone (386) 774-0016

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: rblackwell1675711@adventhealth.direct-ci.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.

Hospital & facility affiliations 6

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": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778371200000",
    "number": "1194414292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 RINEHART RD STE 100",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464885",
            "telephone_number": "407-320-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 RINEHART RD STE 100",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464885",
            "telephone_number": "407-320-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "RAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2026-05-10",
        "certification_date": "2026-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.