Adam Bryce Blacker, O.D., M.S.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1710 Issued in AZ

Practice address

5865 W Utopia Rd
Glendale, AZ 85308-5251

Phone

(623) 572-3919

NPI assigned

Aug 11, 2009

Last updated

Aug 19, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adam.blacker.p3@direct.midwesternuniversity.nextgenshare.com

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.

• Midwestern University

  dba Midwestern University Multispecialty Clinic

  • Multi-Specialty Clinic/Center
  • Glendale, AZ
  • NPI 1932206414

  Optometrist

  Medicare reassignment NPD
• Advanced Vision and Achievement Centers Inc

  • Optometrist
  • Phoenix, AZ
  • NPI 1558553123
  NPD
• Midwestern University

  dba Midwestern University Eye Institute

  • Optometrist
  • Glendale, AZ
  • NPI 1891017745
  NPD
• Midwestern University

  dba Midwestern University Eye Institute-Downers Grove

  • Optometrist
  • Downers Grove, IL
  • NPI 1295126324
  NPD

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1235361197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5865 W UTOPIA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085251",
            "telephone_number": "623-572-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5865 W UTOPIA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085251",
            "telephone_number": "623-572-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKER",
        "first_name": "ADAM",
        "middle_name": "BRYCE",
        "name_prefix": "Dr.",
        "credential": "O.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-11",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1710",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100258",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• BL Med Spa LLC
• Cassandra Blackburn, RN
• Kimberly Irene Blahnik, LPN
• Cody Blair
• Charles Edward Blake, FNP-BC
• Sue Ellen Blakemore, M.N.S. , CCC
• Austin Blalock, PT

• Optometrist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.