Individual provider Active NPI

Mykaila Blumhardt, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1407631096
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1364 Clifton Rd NE
Atlanta, GA 30322-1063
Phone
(404) 712-2000
NPI assigned
Aug 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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 GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Atlanta, GA 30322-1063

Mailing address

1462 Clifton Rd NE Ste 280
Atlanta, GA 30322-1059
Phone (404) 727-7857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260415003698 GA Practitioner - Physician Assistant 9436625670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1407631096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 CLIFTON RD NE STE 280",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-727-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221063",
            "telephone_number": "404-712-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMHARDT",
        "first_name": "MYKAILA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.