Individual provider Active NPI

Cassidy Blank

  • Medical Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1275481384
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9121727 Issued in FL
Practice address
6827 1St Ave S Ste 100
St Petersburg, FL 33707-1242
Phone
(727) 341-0551
Fax
(727) 341-0332
NPI assigned
Mar 17, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 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 9121727 FL Primary

Addresses

Primary practice location

6827 1St Ave S Ste 100
St Petersburg, FL 33707-1242

Mailing address

6827 1St Ave S Ste 100
St Petersburg, FL 33707-1242
Phone (727) 341-0551

Other practice location 1

1301 2nd Ave SW Fl 5
Largo, FL 33770-3120
Phone (727) 341-0551

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260601002523 FL Practitioner - Physician Assistant 9234609165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10002 Princess Palm Ave
Suite 332
Tampa, FL 33619-1357

6421 Congress Ave
Suite 113
Boca Raton, FL 33487-2812

6421 Congress Ave
Suite 113
Boca Raton, FL 33487-2858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9121727FLMDMedical Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1773705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1275481384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6827 1ST AVE S STE 100",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071242",
            "telephone_number": "727-341-0551",
            "fax_number": "727-341-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6827 1ST AVE S STE 100",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071242",
            "telephone_number": "727-341-0551",
            "fax_number": "727-341-0332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 2nd Ave SW Fl 5",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337703120",
            "country_code": "US",
            "telephone_number": "727-341-0551",
            "fax_number": "727-341-0332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANK",
        "first_name": "CASSIDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-17",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9121727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.