Theresa Blue, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9117564 Issued in FL

Practice address

3801 NW 20TH Ave
Ocala, FL 34475-3400

Phone

(352) 216-9222

NPI assigned

Oct 31, 2021

Last updated

Nov 3, 2023By 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 FL

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

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.

• Elyaman Medical Services PA

  dba Absolute Elder Care

  • Family Medicine Physician
  • Ocala, FL
  • NPI 1609251685
  Medicare reassignment

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

{
    "created_epoch": "1635638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1780348219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 NW 20TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344753400",
            "telephone_number": "352-216-9222",
            "fax_number": "352-629-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 NW 20TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344753400",
            "telephone_number": "352-216-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-31",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9117564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blossom and Thrive Counseling and Coaching Inc.
• Blossom Homecare Service LLC
• Dalphine Latanjua Blount
• Isiah Blount
• Jearld Blue II
• Bluesprig
• Bluestar Accident & Injury Care
• Coby Blumberg, MD
• Anelsa Blunt, ARNP
• Kaitlyn J Bly

• Medical Physician Assistant in Ocala, FL
• Providers in Ocala, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.