AMANDA MARIE BLACKLEY (PA-C) – Physician Assistant, NPI 1871002006

AMANDA MARIE BLACKLEY (PA-C) is a healthcare provider. based in Cleveland, Ohio. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 50.005195RX (OH). The NPI Number for AMANDA MARIE BLACKLEY (PA-C) is 1871002006

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA MARIE BLACKLEY (PA-C)
NPI
1871002006
Phone
(216) 444-4037
Address
9500 EUCLID AVE # G62
Enumeration Date
20 September 2017
Last Update Date
20 September 2017

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
2164767000
Graduation Year
2017 (9 years ago)
PAC ID
4082973649
Group Practice PAC ID
1850203555
Professional Enrollment ID
I20180108000292
Address ID
OH441115612CL18101AVEX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

5,036 PHYSICIAN ASSISTANT in OH

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Provider Addresses for AMANDA MARIE BLACKLEY (PA-C)

  • Euclid Avenue, Midtown, Asiatown, Cleveland, Cuyahoga County, Ohio, 44103, United States

    CLEVELAND, OH 441950001

    Phone: (216) 444-4037

    Type: Location

  • 8900, Starlight Drive, Macedonia, Summit County, Ohio, 44056, United States

    MACEDONIA, OH 440561257

    Phone: (440) 488-8797

    Type: Mailing

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: 2018-01-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20180108000292IPhysician AssistantOHTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes1411$0
View full utilization report →

Insurance plans in this area (ZIP 44195)

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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: 1850203555View full group profile
NameSpecialtyState
-NV
Nephrology, Internal MedicineOH
-OH
-MI
Nurse PractitionerOH
General Surgery, Anesthesiology, Critical Care (Intensivists)OH
Certified Registered Nurse Anesthetist (Crna)OH
-OH
-MN
Nurse PractitionerOH

Reviews

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Frequently asked questions

How do payers reference AMANDA MARIE BLACKLEY (PA-C)?
For AMANDA MARIE BLACKLEY (PA-C), use NPI 1871002006 as the unique 10-digit identifier.
Would AMANDA MARIE BLACKLEY (PA-C) appear as active to a payer?
You can treat AMANDA MARIE BLACKLEY (PA-C) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for AMANDA MARIE BLACKLEY (PA-C)?
At a glance, AMANDA MARIE BLACKLEY (PA-C) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Is AMANDA MARIE BLACKLEY (PA-C) associated with Cleveland?
Public fields place AMANDA MARIE BLACKLEY (PA-C) around Cleveland, Ohio. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for AMANDA MARIE BLACKLEY (PA-C) is noted as September 20, 2017 where the registry provides it.

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