NICHOLAS BLAKELY PA-C - NPI 1275345753 - Physician Assistant in San Juan Capistrano, CA

Q: What is Nicholas Blakely's NPI number?

The NPI number for Nicholas Blakely is 1275345753. It was assigned to this individual provider in the NPPES registry on January 22, 2025.

Q: What is Nicholas Blakely's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Blakely was last updated on March 3, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Nicholas Blakely Pa-c NPPES

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

NICHOLAS BLAKELY PA-C (NPI 1275345753) is an individual physician assistant in San Juan Capistrano, California, licensed in California (PA66041) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS and maintains a secondary practice location in Laguna Hills.

NPPES Registry Identity

NPI1275345753

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameNICHOLAS BLAKELYCredential: PA-C

Location Address30230 RANCHO VIEJO RD STE 200San Juan Capistrano, CA 92675-1585

Mailing AddressPo Box 7087Orange, CA 92863-7087 · (714) 571-5000 · Fax (714) 571-5055

Phone(949) 443-4303

Fax(949) 443-4033

Sole ProprietorNo

Enumeration DateJanuary 22, 2025

Last NPPES UpdateMarch 3, 20262 updates tracked since enumeration

NPPES CertifiedMarch 3, 2026

✔ NPI 1275345753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CA · PA66041

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

30230 RANCHO VIEJO RD STE 200, San Juan Capistrano, CA 92675

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Secondary Practice Location 1

Location 123141 Moulton Pkwy Ste 108Laguna Hills, CA 92653-1241 · Phone (949) 443-4303

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicholas Blakely Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92675 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.