DORA BLAIR NELSON (PA-C) – Physician Assistant, NPI 1114764750

DORA BLAIR NELSON (PA-C) is a healthcare provider. based in Johnsonburg, Pennsylvania. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. MA065568 (PA). The NPI Number for DORA BLAIR NELSON (PA-C) is 1114764750

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
DORA BLAIR NELSON (PA-C)
NPI
1114764750
Phone
(814) 512-7126
Address
326 TERRA COTTA RD
Enumeration Date
11 July 2024
Last Update Date
11 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8147888777
Graduation Year
2022 (4 years ago)
PAC ID
5597297572
Group Practice PAC ID
5890689715
Professional Enrollment ID
I20241015003585
Address ID
PA158573484SA761XXRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

9,738 PHYSICIAN ASSISTANT in PA

Provider Addresses for DORA BLAIR NELSON (PA-C)

  • 326 TERRA COTTA RD

    JOHNSONBURG, PA 158451050

    Phone: (814) 512-7126

    Type: Mailing

  • 761 JOHNSONBURG RD

    SAINT MARYS, PA 158573483

    Phone: (814) 512-7126

    Type: Location

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: 2024-10-15

PECOS data refreshed: 2026-06-15

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
I20241015003585IPhysician AssistantPATBD

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 15845)

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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: 5890689715View full group profile

Reviews

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Frequently asked questions

Does DORA BLAIR NELSON (PA-C) have a public NPI I can cite?
Public records show DORA BLAIR NELSON (PA-C) under NPI 1114764750.
Should I treat DORA BLAIR NELSON (PA-C) as an active provider?
Patients and plans typically see DORA BLAIR NELSON (PA-C) as active in the national extract.
What services align with DORA BLAIR NELSON (PA-C)'s listing?
DORA BLAIR NELSON (PA-C)'s public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
Which community is linked to DORA BLAIR NELSON (PA-C)?
DORA BLAIR NELSON (PA-C) shows a connection to Johnsonburg, Pennsylvania in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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