MS. VICKI M BLACKWELL PA
NPI 1043235963
Physician Assistant - Surgical in Tampa, FL

Q: What is Vicki Blackwell's NPI number?

The NPI number for Vicki Blackwell is 1043235963. It was assigned to this individual provider in the NPPES registry on July 12, 2006. The provider is also known as Vicki M Burleson Pa-C.

Q: What is Vicki Blackwell's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Vicki Blackwell was last updated on May 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 12, 2006PECOS EnrolledAccepts Medicare Assignment

3657 MADACA LN, TAMPA, FL 33618(800) 991-6117 Get Directions Write a Review

NPPES record last updated: May 1, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Ms. Vicki M Blackwell Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. VICKI M BLACKWELL PA (NPI 1043235963) is an individual surgical provider in Tampa, Florida, licensed in Florida (PA9120078) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1043235963

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameMS. VICKI M BLACKWELLCredential: PA

Location Address3657 MADACA LNTampa, FL 33618-2048

Mailing Address3820 Northdale Blvd Ste 201Tampa, FL 33624-1893 · (800) 991-6117

Phone(800) 991-6117

Sole ProprietorNo

Medical School CMSOtherGraduated 1995

Enumeration DateJuly 12, 2006

Last NPPES UpdateMay 1, 2025

NPPES CertifiedMay 1, 2025

✔ NPI 1043235963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · PA9120078

3657 MADACA LN, Tampa, FL 33618

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Other Names 1

Former Name (1)Vicki M Burleson Pa-c

Other Identifiers 3

Medicaid051553463AL

OtherP00010094AL · Rr Medicare

Other51514981BURAL · Blue Cross Of Alabama

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Blue Cross and Blue Shield of Alabama, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Vicki M Blackwell Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810063203

PECOS Enrollment IDI20250509002648

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

34 services21 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Controlling High Blood Pressure

49%53 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

99%529 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

75%259 patients4/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

1%129 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

20%116 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 71% · 248 patients

Patients screened: 73% · 248 patients

84%38 patients4/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 64 patients

Patients totalRate: 4% · 28 patients

4%28 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WAZNI, PLLC

Surgery (Vascular Surgery)