SHELBY L BLACKLEY
NPI 1518584259
Physician Assistant - Surgical in Trumbull, CT
NPI Status: Active since June 29, 2020
Contact Information
5520 PARK AVE STE WP-2300
TRUMBULL, CT
ZIP 06611
Phone: (203) 374-0310
- Individual
- Female
- Physician Assistant
- Surgical
- PECOS Enrolled
About SHELBY BLACKLEY
This page provides the complete NPI Profile along with additional information for Shelby Blackley, a provider established in Trumbull, Connecticut with a medical specialization in Physician Assistant, focusing in surgical . The healthcare provider is registered in the NPI registry with number 1518584259 assigned on June 2020. The practitioner's primary taxonomy code is 363AS0400X with license number 4908 (CT). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1518584259
- Provider Name
- SHELBY L BLACKLEY
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 5520 PARK AVE STE WP-2300 TRUMBULL, CT 06611
- Location Phone
- (203) 374-0310
- Mailing Address
- 60 METROPOLITAN PARK DR RIVERSIDE, RI 02915
- Mailing Phone
- (508) 463-7929
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-29-2020
- Last Update Date
- 10-01-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Surgical
- Taxonomy Code
- 363AS0400X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 4908
- License State
- CT
Medicare Participation & PECOS Enrollment Status
Shelby Blackley is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1518584259, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1518584259, enumerated as an "individual" on June 29, 2020.
The provider is located at 5520 PARK AVE STE WP-2300 TRUMBULL, CT 06611 and the phone number is (203) 374-0310.
Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.
