Rebecca Marie Blume, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10000655A Issued in IN

Practice address

3919 W Jefferson Blvd Ste 25a
Fort Wayne, IN 46804-6811

Phone

(260) 436-7722

Fax

(260) 459-0012

NPI assigned

Sep 27, 2006

Last updated

Dec 2, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Jefferson Park Pediatrics P C

  • Pediatrics Physician
  • Fort Wayne, IN
  • NPI 1629263181
  Medicare reassignment
• Jefferson Pediatrics, PC

  • Family Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1134542855
  NPD (past)
• Pediatrics Center of Fort Wayne, P.C.

  • Pediatrics Physician
  • Fort Wayne, IN
  • NPI 1568595999
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1679664379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18028 FOGEL RD",
            "city": "CHURUBUSCO",
            "state": "IN",
            "postal_code": "467239213",
            "telephone_number": "260-312-7733",
            "fax_number": "855-284-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 W JEFFERSON BLVD STE 25A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046811",
            "telephone_number": "260-436-7722",
            "fax_number": "260-459-0012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18028 Fogel Rd",
            "address_purpose": "LOCATION",
            "city": "Churubusco",
            "state": "IN",
            "postal_code": "467239213",
            "country_code": "US",
            "telephone_number": "260-312-7733",
            "fax_number": "855-284-1343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUME",
        "first_name": "REBECCA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000655A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Blowers, NP
• Blue Crescent Blue Star Medical of Indiana, Inc
• Corey M Blum
• Michael Lloyd Blum, M.D.
• James Ervin Blume, O.D.
• Emanuel Lucian Boar, PT
• Bonnie Boatwright, LPN
• Lisa S Bobay, PA-C
• Nicole M Bobay, MPT, WCS, CIMT, CSCS
• Jared Bobcean, MT-BC

• Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.