NORMA LYNN BLACKWATER M.D.
NPI 1457476038
General Practice in Los Angeles, CA

Q: What is Norma Blackwater's NPI number?

The NPI number for Norma Blackwater is 1457476038. It was assigned to this individual provider in the NPPES registry on March 20, 2007.

Q: What is Norma Blackwater's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Norma Blackwater was last updated on December 8, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 20, 2007PECOS EnrolledAccepts Medicare Assignment

1125 W 6TH ST, SUITE 103, LOS ANGELES, CA 90017(213) 202-3970(213) 975-9257 Get Directions Write a Review

NPPES record last updated: December 8, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Norma Lynn Blackwater M.d. NPPES

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

NORMA LYNN BLACKWATER M.D. (NPI 1457476038) is an individual general practice provider in Los Angeles, California, licensed in California (G83912) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and is a graduate of University Of North Dakota School Of Medicine (1993).

NPPES Registry Identity

NPI1457476038

Entity TypeIndividualFemale

Primary Taxonomy208D00000X

Provider Legal NameNORMA LYNN BLACKWATERCredential: M.D.

Location Address1125 W 6TH ST, SUITE 103Los Angeles, CA 90017-1833

Mailing Address1125 W 6th St, Suite 103Los Angeles, CA 90017-1833 · (213) 202-3970 · Fax (213) 975-9257

Phone(213) 202-3970

Fax(213) 975-9257

Sole ProprietorNo

Medical School CMSUniversity Of North Dakota School Of MedicineGraduated 1993

Enumeration DateMarch 20, 2007

Last NPPES UpdateDecember 8, 2011

✔ NPI 1457476038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in CA · G83912

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

1125 W 6TH ST, Los Angeles, CA 90017

Open in Google Maps ↗

Other Identifiers 1

Medicaid00G839120CA

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

Norma Lynn Blackwater M.d. 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 ID9133392988

PECOS Enrollment IDI20260422001373

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.

Other Providers at the Same Location NPPES 20

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

PATRICIA LOPEZ RNP

Nurse Practitioner

1125 W 6TH ST, SUITE 103
LOS ANGELES, CA 90017

Los Angeles County (213) 202-3970

BETTINA ANDERSEN SCHNEIDERMAN MFC

Marriage & Family Therapist