Active NPI
Blakeley Elizabeth Burleson, PA-C
- Medical Physician Assistant
- Clearwater, FL
National Provider Identifier
1245740422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9114793
- Practice address
- 3301 N McMullen Booth Rd
Clearwater, FL 33761-2014 - Phone
- (872) 231-3162
- Fax
- (702) 977-1496
- NPI assigned
- Oct 2, 2017
- Last updated
- Oct 3, 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9114793 | FL | Primary |
Addresses
Primary practice location
3301 N McMullen Booth Rd
Clearwater, FL 33761-2014
Mailing address
PO Box 7410884
Chicago, IL 60674-0884
Phone (702) 899-0595
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3406 | TN | MD | Optometrist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- NPI 1265453286
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- Altamonte SPG, FL
- NPI 1245700244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759449600000",
"number": "1245740422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7410884",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606740884",
"telephone_number": "702-899-0595",
"fax_number": "702-977-1496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 N MCMULLEN BOOTH RD",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337612014",
"telephone_number": "872-231-3162",
"fax_number": "702-977-1496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURLESON",
"first_name": "BLAKELEY",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-02",
"last_updated": "2025-10-03",
"certification_date": "2025-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9114793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.