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MR. DOUGLAS ALAN BLAZER PA
NPI 1104101823
Physician Assistant - Medical in Rockford, IL

Active since October 13, 2011PECOS EnrolledAccepts Medicare Assignment
3475 S ALPINE RD, ROCKFORD, IL 61109(815) 874-8000 Get Directions Write a Review

NPPES record last updated: October 13, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Douglas Alan Blazer Pa NPPES

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

MR. DOUGLAS ALAN BLAZER PA (NPI 1104101823) is an individual medical provider in Rockford, Illinois, licensed in Illinois (085004130) and active in the NPI registry since October 2011. He is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1104101823
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. DOUGLAS ALAN BLAZERCredential: PA
Location Address3475 S ALPINE RDRockford, IL 61109-2604
Mailing Address3475 S Alpine RdRockford, IL 61109-2604 · (815) 874-8000
Phone(815) 874-8000
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateOctober 13, 2011
✔ NPI 1104101823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in IL · 085004130
3475 S ALPINE RD, Rockford, IL 61109
Open in Google Maps ↗

Other Identifiers 1

Other085004130IL · State Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware 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

Mr. Douglas Alan Blazer 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 ID9638344930
PECOS Enrollment IDI20111215000394
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 11

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.
122 services99 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
98 services85 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
55 services55 patients
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811
This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
54 services51 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
53 services46 patients
Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
50 services25 patients

Other Providers at the Same Location NPPES 9

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

LINDSEY JACOBSON PTA
Physical Therapy Assistant
3475 S ALPINE RD
ROCKFORD, IL 61109
Winnebago County (815) 874-8000
THERESA ANN KNOLL MPT
Physical Therapist
3475 S ALPINE RD, PHYSICIANS IMMEDIATE CARE
ROCKFORD, IL 61109
Winnebago County (815) 874-8000
LINDSAY N COX BECKER PTA
Physical Therapy Assistant
3475 S ALPINE RD
ROCKFORD, IL 61109
Winnebago County (815) 874-8000
MR. WILLIAM C. HELLYER JR. MBA, OTR/L
Occupational Therapist
3475 S ALPINE RD
ROCKFORD, IL 61109
Winnebago County (815) 874-8000
PHYSICIANS IMMEDIATE CARE LTD
Clinic/Center (Urgent Care)
3475 S ALPINE RD
ROCKFORD, IL 61109
Winnebago County (815) 874-8000
FRANCISCO GABRIEL SOTELO ACEVES PTA
Physical Therapy Assistant
3475 S ALPINE RD
ROCKFORD, IL 61109
Winnebago County (815) 261-9047
KIMBERLY RAE SHULGA APRN, FNP-C
Nurse Practitioner (Family)
3475 S ALPINE RD
ROCKFORD, IL 61109
Winnebago County (815) 874-8000
JULIE L BAILOR PT
Physical Therapist
3475 S ALPINE RD
ROCKFORD, IL 61109
Winnebago County (815) 874-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Blazer's NPI number?

The NPI number for Douglas Blazer is 1104101823. It was assigned to this individual provider in the NPPES registry on October 13, 2011.

Where is Douglas Blazer located?

Douglas Blazer practices at 3475 S Alpine Rd, Rockford, IL 61109. The listed phone number is (815) 874-8000.

What is Douglas Blazer's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Douglas Blazer enrolled in Medicare?

Yes. Douglas Blazer is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Douglas Blazer accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and Blue Cross and Blue Shield of Texas list Douglas Blazer as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Douglas Blazer was last updated on October 13, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.