Individual provider Active NPI

Christin Rentzel Blazevich, APRN

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1831836956
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1073233 Issued in TX
Practice address
3500 Gaston Ave
Dallas, TX 75246-2088
Phone
(214) 820-0111
NPI assigned
May 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1073233 TX Primary

Addresses

Primary practice location

3500 Gaston Ave
Dallas, TX 75246-2088

Mailing address

5615 Ridgedale Ave
Dallas, TX 75206-6015
Phone (214) 538-3681

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230309001521 TX Practitioner - Nurse Practitioner 6800269093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3410 Worth St
250 Baylor Scott and White Medprovider
Dallas, TX 75246-2073
Phone (214) 820-6856

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Feb 28, 2023 Accepting new patients
Healthtexas Provider Network CurrentSince Feb 28, 2023 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

3500 Gaston Ave
Dallas, TX 75246

3410 Worth St
Ste 250
Dallas, TX 75246
Phone (214) 820-6856

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

Organizations & group practices 3

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 1

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": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1831836956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 RIDGEDALE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752066015",
            "telephone_number": "214-538-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462088",
            "telephone_number": "214-820-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZEVICH",
        "first_name": "CHRISTIN",
        "middle_name": "RENTZEL",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1073233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.