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DR. THOMASINA BLACKWATER MD
NPI 1356915037
Family Medicine in Los Angeles, CA

Active since May 17, 2021PECOS Enrolled
1300 N MISSION RD FL 2, LOS ANGELES, CA 90033(323) 409-8255 Get Directions Write a Review

NPPES record last updated: July 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Thomasina Blackwater Md NPPES

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

DR. THOMASINA BLACKWATER MD (NPI 1356915037) is an individual family medicine provider in Los Angeles, California, licensed in California (A203016) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1356915037
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. THOMASINA BLACKWATERCredential: MD
Location Address1300 N MISSION RD FL 2Los Angeles, CA 90033-1021
Mailing Address550 S Palos Verdes St Apt 632San Pedro, CA 90731-5126 · (520) 235-4831
Phone(323) 409-8255
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMay 17, 2021
Last NPPES UpdateJuly 21, 2025
NPPES CertifiedJuly 21, 2025
✔ NPI 1356915037 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A203016
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1300 N MISSION RD FL 2, Los Angeles, CA 90033
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Thomasina Blackwater Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7517469349
PECOS Enrollment IDI20250909002178
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 90033 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
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Thomasina Blackwater's NPI number?

The NPI number for Thomasina Blackwater is 1356915037. It was assigned to this individual provider in the NPPES registry on May 17, 2021.

Where is Thomasina Blackwater located?

Thomasina Blackwater practices at 1300 N Mission Rd Fl 2, Los Angeles, CA 90033. The listed phone number is (323) 409-8255.

What is Thomasina Blackwater's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Thomasina Blackwater enrolled in Medicare?

Yes. Thomasina Blackwater is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Thomasina Blackwater was last updated on July 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.