DR. BLAYNE K STREET (D.O.) – Pediatrics Physician, NPI 1568811636

DR. BLAYNE K STREET (D.O.) is a healthcare provider. based in Sweetwater, Texas. specializing in PEDIATRIC MEDICINE. They hold the professional credentials D.O.. They hold a License No. S6314 (TX). The NPI Number for DR. BLAYNE K STREET (D.O.) is 1568811636

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
DR. BLAYNE K STREET (D.O.)
NPI
1568811636
Phone
(325) 219-6175
Address
301 JENNY GEORGE LANE
Enumeration Date
8 June 2016
Last Update Date
13 June 2022

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Secondary Phone
3252356814
Graduation Year
2016 (10 years ago)
PAC ID
0042502809
Group Practice PAC ID
6608025176
Professional Enrollment ID
I20210726001959
Address ID
TX795567152SW301XXLNXX404

Contacts

FHIR Endpoint
bstreet@rpmh.net
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness85
Years active:10State licenses:1Other namesUpdated within 12 months

2,256 PEDIATRIC MEDICINE in TX

Provider Addresses for DR. BLAYNE K STREET (D.O.)

  • 301 JENNY GEORGE LANE

    BUILDING B, SUITE 5

    SWEETWATER, TX 79556

    Phone: (325) 219-6175

    Fax: (325) 219-6179

    Type: Location

  • 11130 CHRISTUS HILLS

    MEDICAL PLAZA 3, 3RD FL

    SAN ANTONIO, TX 782513585

    Phone: (210) 703-9001

    Fax: (210) 703-9155

    Type: Mailing

  • 301 JENNY GEORGE LN

    BUILDING B, SUITE 5

    SWEETWATER, TX 795567152

    Phone: (325) 219-6175

    Fax: (325) 219-6179

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2021-07-26

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
I20210726001959IPediatric MedicineTXTBD

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 79556)

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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: 6608025176View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX
General SurgeryKS
Family Practice, Obstetrics/GynecologyTX
Orthopedic SurgeryMS

Reviews

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Frequently asked questions

What identifier follows DR. BLAYNE K STREET (D.O.) across health systems?
The NPI 1568811636 uniquely identifies DR. BLAYNE K STREET (D.O.) in U.S. healthcare data.
Does the public listing show DR. BLAYNE K STREET (D.O.) as active?
DR. BLAYNE K STREET (D.O.)'s NPI record reflects an active status in NPPES.
How should patients interpret DR. BLAYNE K STREET (D.O.)'s specialty?
The extract shows Pediatrics Physician for DR. BLAYNE K STREET (D.O.). Clinical services aligned with this taxonomy classification.
Is DR. BLAYNE K STREET (D.O.) tied to Sweetwater, Texas?
If you are local to Sweetwater, Texas, DR. BLAYNE K STREET (D.O.) may be relevant to your search.
Can I export DR. BLAYNE K STREET (D.O.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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