Blackstone Medical Services LLC

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

BLACKSTONE MEDICAL SERVICES LLC

Practice address

550 N Reo St Ste 250
Tampa, FL 33609-1039

Phone

(813) 831-2727

Fax

(888) 239-4616

NPI assigned

Mar 16, 2011

Organization subpart

No

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

Authorized official

Name

Vick Tipnes

Title

Ceo

Phone

(813) 831-2727

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Blackstone Medical Services Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Blackstone Medical Services LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Burtonsville, MD
  • NPI 1265043897

  2961658554

  Same PAC ID

Tax ID family

Blackstone Medical Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Blackstone Medical Services LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Burtonsville, MD
  • NPI 1265043897
  NPD tax ID

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• HealthSun Health Plans Network
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David C Brodner, MD

  • Specialist
  • Boynton Beach, FL
  • NPI 1144284902
  NPD
• Brett M Scotch, D.O.

  • Otolaryngology Physician
  • Wesley Chapel, FL
  • NPI 1770577090
  NPD
• Omavi Bailey, MD MPH

  • Sleep Medicine (Family Medicine) Physician
  • Fayetteville, NC
  • NPI 1982010203
  NPD

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759449600000",
    "number": "1699074716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 HENDERSON BLVD STE 145",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336294940",
            "telephone_number": "813-831-2727",
            "fax_number": "888-239-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N REO ST STE 250",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091039",
            "telephone_number": "813-831-2727",
            "fax_number": "888-239-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSTONE MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-16",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A",
        "authorized_official_last_name": "TIPNES",
        "authorized_official_first_name": "VICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-831-2727"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017677000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "http://secure2.abbadox.com/AbbaDox/Login.aspx",
            "affiliation": "N",
            "endpointDescription": "Medical Records",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Medical Records",
            "address_1": "550 N Reo St Ste 250",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336091039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Blackstone Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Gautier Blackman, PA-C
• Absalom Blackmon, RKT, LMT,MMP,CPS
• Brittany Blackmon
• Jovan Deniro Blackmon Jr.
• Maritza Blackshaw, RDH
• Dan Steven Blackwelder, DDS
• Deborah Blackwell Owensby
• Deandre D Blackwell
• Grayson Blackwell
• Vicki M Blackwell, PA

• Sleep Disorder Diagnostic Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Sleep Disorder Diagnostic Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.