Individual provider Active NPI

Blakely Austin Deboard

  • Certified Registered Nurse Anesthetist
  • St Petersburg, FL
National Provider Identifier
1720623499
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11005487 Issued in FL
Practice address
6000 49TH St N
St Petersburg, FL 33709-2114
Phone
(727) 521-4411
NPI assigned
Nov 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9444134 FL
Certified Registered Nurse Anesthetist 367500000X APRN11005487 FL Primary

Addresses

Primary practice location

6000 49TH St N
St Petersburg, FL 33709-2114

Mailing address

6918 Neopolitan CT
Apollo Beach, FL 33572-1604
Phone (813) 304-3383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200423002357 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799115259 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 321-6589

3003 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9444134FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Apr 5, 2020 Accepting new patients
Sunshine State Anesthesia Partners LLC CurrentSince Feb 28, 2021 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 5, 2022 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Nov 2, 2023 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 23, 2023 Accepting new patients
Baycare Medical Group, Inc CurrentSince Nov 2, 2023 Accepting new patients
American Anesthesiology Services of Florida, Inc. CurrentSince Sep 2, 2022 Accepting new patients
Baycare Medical Group, Inc. Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Apr 5, 2020 Accepting new patients
Digestive Anesthesia Associates LLC CurrentSince Jul 15, 2022 Accepting new patients

Locations

401 Corbett St
Ste 220
Belleair, FL 33756
Phone (727) 388-7326

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 333-2050

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

110 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 527-1825

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

204B E 19th St
Panama City, FL 32405
Phone (850) 769-7599

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

2438 Dr Ml King Jr St N
St Petersburg, FL 33704
Phone (727) 565-0740

5771 49th St N
St Petersburg, FL 33709
Phone (727) 443-4299

5771 49th St N
Ste 157
St Petersburg, FL 33709

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

3001 W Mlk Blvd
Tampa, FL 33607
Phone (813) 361-6778

2901 W Swann Ave
Tampa, FL 33609
Phone (813) 783-6400

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Networks

  • Freedom Health HMO Network

Organizations & group practices 10

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.

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": "1573862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1720623499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6918 NEOPOLITAN CT",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335721604",
            "telephone_number": "813-304-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092114",
            "telephone_number": "727-521-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOARD",
        "first_name": "BLAKELY",
        "middle_name": "AUSTIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-16",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9444134",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11005487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.