Individual provider Active NPI

James Allen Blackburn, PA-C

  • Physician Assistant
  • Webster, TX
National Provider Identifier
1376543553
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02302 Issued in TX
Practice address
500 N Kobayashi Ste C
Webster, TX 77598-4722
Phone
(281) 747-9313
Fax
(281) 724-0487
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 PA02302 TX Primary

Addresses

Primary practice location

500 N Kobayashi Ste C
Webster, TX 77598-4722

Mailing address

PO Box 58662
Webster, TX 77598-8662
Phone (281) 747-9313

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
I20040512000152 TX Practitioner - Physician Assistant 9133115967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Webster Rehabilitation Specialists LLCGroup PAC ID 7315201910, 7 clinicians

Practice addresses (Care Compare)

500 N Kobayashi
Webster, TX 77598-4722
Phone (281) 747-9313

Hospital & facility affiliations

  • HCA Houston Healthcare Clear Lake Hospital, Webster, TX, CCN 450617
  • Clear Lake Regional Medical Center Inpatient rehabilitation facility, Webster, TX, CCN 45T617

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cesar Nahas MD PA PastSince Nov 1, 2013 Accepting new patients

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 2

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1376543553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58662",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775988662",
            "telephone_number": "281-747-9313",
            "fax_number": "281-724-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N KOBAYASHI STE C",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984722",
            "telephone_number": "281-747-9313",
            "fax_number": "281-724-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "JAMES",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.