Andrew Blakely, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A147398 Issued in CA

Practice address

1500 Duarte Rd
Duarte, CA 91010-3012

Phone

(626) 256-4673

NPI assigned

May 11, 2010

Last updated

Jul 21, 2022By 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 MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ablakely735834@direct.hopkinsmedicine.org

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.

• Carroll Health Group, LLC

  • Internal Medicine Physician
  • Westminster, MD
  • NPI 1437473550

  Surgery

  Medicare reassignment NPD
• Carroll Health Group, LLC

  • Surgery Physician
  • Westminster, MD
  • NPI 1194512319
  NPD (past)

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386962603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185",
            "telephone_number": "626-775-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DUARTE RD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910103012",
            "telephone_number": "626-256-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-5180",
            "fax_number": "401-444-6681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "LP01881",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A147398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dhvani Dipak Bhatt, R.D.
• Korie Bigbee
• Heather Nicole Bitar, D.O.
• Courtney Bitz, LCSW
• Amanda L Blackmon
• Franz Edward Boas, MD, PHD
• Heather Del Villar Bogdanov, N.P.
• Veronica Janell Bolanos, FNP
• Kimberly Bolivar, M.D.
• Ellen Bolotin, MD

• Surgery Physician in Duarte, CA
• Providers in Duarte, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.