Amelia E Blydenburgh

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1831 Paisley St
San Antonio, TX 78231-2419

Phone

(210) 609-8578

NPI assigned

Aug 22, 2023

Last updated

Aug 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 NY

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Planned Parenthood of the North Country New York, Inc.

  • Ambulatory Family Planning Facility
  • Watertown, NY
  • NPI 1407907215
  Medicare reassignment NPD

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1942084926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 PAISLEY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782312419",
            "telephone_number": "210-609-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 PAISLEY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782312419",
            "telephone_number": "210-609-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLYDENBURGH",
        "first_name": "AMELIA",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald L. Blumoff, M.D.
• Camille Jones Blundell, LMSW
• Seth Blundell
• Sherry Lea Blundell, PTA
• Laurel Bluntzer, PSYD
• Joseph Meran Blydenburgh Jr., P.A.
• BMC Physicians PLLC
• BML Dental, PLLC
• Agnes Boachie
• Tracy G. Board, AU.D.

• Student in an Organized Health Care Education/Training Program in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.
• 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.