Active NPI
Monika Blackmon
- Physician Assistant
- Naples, FL
National Provider Identifier
1922767425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 4513 Executive Dr
Naples, FL 34119-9033 - Phone
- (239) 431-6464
- NPI assigned
- Dec 12, 2021
- Last updated
- Apr 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
4513 Executive Dr
Naples, FL 34119-9033
Mailing address
4513 Executive Dr
Naples, FL 34119-9033
Phone (239) 431-6464
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
19910 S Tamiami TRL
Suite B
Estero, FL 33928-4140
Phone (239) 263-1717
801 Anchor Rode Dr
Suite 100
Naples, FL 34103-2742
Phone (239) 263-1717
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Coastal Surgery Center, Inc | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Dermatology Physician
- Naples, FL
- NPI 1518189927
-
dba Premier Medical Associates
- Internal Medicine Physician
- The Villages, FL
- NPI 1093829442
-
- Internal Medicine Physician
- The Villages, FL
- NPI 1023612827
-
- Ambulatory Surgical Clinic/Center
- Naples, FL
- NPI 1003812686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650326400000",
"number": "1922767425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4513 EXECUTIVE DR",
"city": "NAPLES",
"state": "FL",
"postal_code": "341199033",
"telephone_number": "239-431-6464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4513 EXECUTIVE DR",
"city": "NAPLES",
"state": "FL",
"postal_code": "341199033",
"telephone_number": "239-431-6464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMON",
"first_name": "MONIKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-12",
"last_updated": "2022-04-19",
"certification_date": "2022-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.
- 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.