Andrea P Blankenship, PA-C
Individual provider Active NPI Physician Assistant · Pikeville, KY
NPI 1659322337 · NPPES record last updated Nov 10, 2015
Key facts
- NPI
- 1659322337
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA827 (KY)
- Practice address
- 1098 S Mayo TRL
Pikeville, KY 41501-1546 - Phone
- (606) 432-5532
- Fax
- (606) 432-5564
- NPI assigned
- May 15, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Kentucky College of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Modern Dermatology of Kentucky LLC
Practice addresses (Care Compare)
1098 S Mayo TRL
Pikeville, KY 41501-1546
Phone (859) 276-1511
1750 Hwy 192 W
Suite 8
London, KY 40741-2640
Phone (859) 276-1511
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040615000057 | KY | Practitioner - Physician Assistant | 1557345956 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA827 | KY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ronald D Hall MD | Past | Accepting new patients | |
| Kentucky Dermatology and Skin Cancer Clinic, PSC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA827 | KY | Yes |
Addresses
Primary practice location
1098 S Mayo TRL
Pikeville, KY 41501-1546
Mailing address
PO Box 2500
Pikeville, KY 41502-2500
Phone (606) 432-5532
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000327326 | Other | KY | ANTHEM OF KY |
| 9500436200 | Medicaid | KY |
Other providers in Pikeville, KY
- Allison Blackburn
- Erica Blackburn
- John W Blackburn
- Michelle Lee Blackburn
- Jessica Blair
- Melissa Blankenship
- Bluegrass Family Walk-in Clinic LLC
- Bluegrass Oxygen Inc
- Alisha Bolen
- Kelly Cahill Bollard
All providers in Pikeville, KY · Physician Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.