MS. VICKI M BLACKWELL PA
NPI 1043235963
Physician Assistant - Surgical in Tampa, FL
NPI Status: Active since July 12, 2006
- Individual
- Female
- Years of Experience 31
- Physician Assistant
- Surgical
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About VICKI BLACKWELL
This page provides the complete NPI Profile along with additional information for Vicki Blackwell, a provider established in Tampa, Florida with a medical specialization in Physician Assistant, focusing in surgical and more than 31 years of experience. The healthcare provider is registered in the NPI registry with number 1043235963 assigned on July 2006. The practitioner's primary taxonomy code is 363AS0400X with license number PA9120078 (FL). The provider is registered as an individual and her NPI record was last updated May 2025.
- NPI
- 1043235963
- Provider Name
- MS. VICKI M BLACKWELL PA
- Other Name
- VICKI M BURLESON PA-C
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 3657 MADACA LN TAMPA, FL 33618
- Location Phone
- (800) 991-6117
- Mailing Address
- 3820 NORTHDALE BLVD STE 201 TAMPA, FL 33624
- Mailing Phone
- (800) 991-6117
- Medical School Name
- OTHER
- Graduation Year
- 1995
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-12-2006
- Last Update Date
- 05-01-2025
- Code Navigator
Location Map
Secondary Locations
- 2010 Patton Chapel Rd Ste 200
Vestavia Hills, AL 35216
(205) 910-7599
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Surgical
- Taxonomy Code
- 363AS0400X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA9120078
- License State
- FL
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue HSA Bronze - PPO
- Blue Protect - PPO
- Blue Saver Bronze - PPO
- Blue Saver Silver EPO - EPO
- Blue Standardized Silver EPO - EPO
- Blue Value Gold - PPO
- Blue Value Silver - PPO
- Blue Access Gold for Business - PPO
- Blue Choice Platinum for Business - PPO
- Blue HSA Silver for Business - PPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
- UHC Silver Value ($0 Virtual Urgent Care, $2 Tier 2 Rx, No Referrals) - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 051553463 | MEDICAID (05) | AL | |
| P00010094 | OTHER (01) | AL | RR MEDICARE |
| 51514981BUR | OTHER (01) | AL | BLUE CROSS OF ALABAMA |
Medicare Participation & PECOS Enrollment Status
Vicki Blackwell is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Vicki Blackwell is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 7810063203
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20080909000417
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Documentation of Current Medications in the Medical Record | 100% | 593 |
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 44% | 271 |
| Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented | 20% | 485 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 79% | 34 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 67% | 79 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 63% | 265 |
| Use of High-Risk Medications in Older Adults | 33% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 45 |
| Use of High-Risk Medications in Older Adults | 5% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 20 |
| Use of High-Risk Medications in Older Adults | 27% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 45 |
Reviews for MS. VICKI M BLACKWELL PA
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 4 | 3 | 2 | 3 | 5 | 9 | 6 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 8 | 3 | 4 | 3 | 10 | 9 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 8 + 3 + 4 + 3 + 1 + 0 + 9 + 1 + 2 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1043235963 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1346660958 | SETH BROWN MD Individual | Radiology (Vascular & Interventional Radiology) | 3657 MADACA LN TAMPA, FL 33618 (800) 991-6117 |
| 1114353026 | WAZNI, PLLC Organization | Surgery (Vascular Surgery) | 3657 MADACA LN TAMPA, FL 33618 (800) 991-6117 |
| 1184610453 | DR. WILLIAM KIANG DO Individual | Surgery (Vascular Surgery) | 3657 MADACA LN TAMPA, FL 33618 (800) 991-6117 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043235963, enumerated in the NPI registry as an "individual" on July 12, 2006
The provider is located at 3657 Madaca Ln Tampa, Fl 33618 and the phone number is (800) 991-6117
The provider's speciality is Physician Assistant with taxonomy code 363AS0400X with a focus in Surgical
The provider has more than 31 years of experience.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Alabama,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
The provider obtained a high score in the following performance measures: Documentation of Current Medications in the Medical Record , Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention. The quality ratings are based on unbiased reviews and reported submissions to Medicare's Quality Payment Program.
This NPI record was last updated on July 12, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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