MATTHEW JEREMY BLAKEMORE (P.A.) – Physician Assistant, NPI 1134653827

MATTHEW JEREMY BLAKEMORE (P.A.) is a healthcare provider. based in Fort myers, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. PA9110051 (FL). The NPI Number for MATTHEW JEREMY BLAKEMORE (P.A.) is 1134653827

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
MATTHEW JEREMY BLAKEMORE (P.A.)
NPI
1134653827
Phone
(239) 344-9786
Address
6150 DIAMOND CENTRE CT STE 1300
Enumeration Date
19 April 2017
Last Update Date
22 May 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9542298635
Graduation Year
2016 (10 years ago)
PAC ID
3375820194
Group Practice PAC ID
1658688304
Professional Enrollment ID
I20190626000347
Address ID
FL333344149FO1000XSTXX400

Contacts

Secure Messaging
Matt@Surgicalhealingarts.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:9State licenses:1Other namesUpdated within 12 months

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for MATTHEW JEREMY BLAKEMORE (P.A.)

  • 6150 DIAMOND CENTRE CT STE 1300

    FORT MYERS, FL 339124367

    Phone: (239) 344-9786

    Fax: (239) 344-9215

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-06-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170504001272IPhysician AssistantMOTBD
I20190626000347IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33912)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658688304View full group profile
NameSpecialtyState
-FL
Physician AssistantFL
-FL
Physician AssistantFL
Nurse PractitionerFL
-FL
Physician AssistantFL
Physician AssistantPA
Physician AssistantNC
Physician AssistantFL

Reviews

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Frequently asked questions

How do payers reference MATTHEW JEREMY BLAKEMORE (P.A.)?
For MATTHEW JEREMY BLAKEMORE (P.A.), use NPI 1134653827 as the unique 10-digit identifier.
Is MATTHEW JEREMY BLAKEMORE (P.A.) shown as active in public data?
Registry records indicate MATTHEW JEREMY BLAKEMORE (P.A.) maintains an active NPI.
What clinical focus is listed for MATTHEW JEREMY BLAKEMORE (P.A.)?
At a glance, MATTHEW JEREMY BLAKEMORE (P.A.) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Is MATTHEW JEREMY BLAKEMORE (P.A.) located near Fort Myers?
MATTHEW JEREMY BLAKEMORE (P.A.) currently maps to Fort Myers, Florida in this extract.
Can I trust this NPI listing for MATTHEW JEREMY BLAKEMORE (P.A.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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