Individual provider Active NPI

Victoria Renee Blau

  • Physician Assistant
  • Morehead City, NC
National Provider Identifier
1477316461
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
302 Medical Park CT
Morehead City, NC 28557-4346
Phone
(252) 247-2013
NPI assigned
Feb 1, 2024
Last updated
Jan 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 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 NU Primary

Addresses

Primary practice location

302 Medical Park CT
Morehead City, NC 28557-4346

Mailing address

302 Medical Park CT
Morehead City, NC 28557-4346
Phone (252) 247-2013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250312003029 NC Practitioner - Physician Assistant 7618498148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carteret Medical Group LLCGroup PAC ID 5698947794, 65 clinicians

Practice addresses (Care Compare)

1165 Cedar Point Blvd
Cedar Point, NC 28584-1030

302 Medical Park CT
Morehead City, NC 28557-4346
Phone (252) 247-2013

306 Medical Park CT
Morehead City, NC 28557-4346
Phone (252) 247-2101

338 Howard Blvd
Newport, NC 28570-7928
Phone (252) 499-8500

3500 Arendell St
Morehead City, NC 28557-2901
Phone (252) 247-2013

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: victoria.blau.1@15484.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1477316461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 MEDICAL PARK CT",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574346",
            "telephone_number": "252-247-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 MEDICAL PARK CT",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574346",
            "telephone_number": "252-247-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAU",
        "first_name": "VICTORIA",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-01",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

Verify at the official NPI Registry.