KELLIE JASMINE BLANK PA-C
NPI 1659989630
Physician Assistant in Wyandotte, MI

Q: What is Kellie Blank's NPI number?

The NPI number for Kellie Blank is 1659989630. It was assigned to this individual provider in the NPPES registry on July 16, 2020.

Q: What is Kellie Blank'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 Kellie Blank was last updated on September 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since July 16, 2020PECOS EnrolledAccepts Medicare Assignment

2333 BIDDLE AVE, WYANDOTTE, MI 48192(734) 246-6000 Get Directions Write a Review

NPPES record last updated: September 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 7, 2024, Aug 8, 2023, Jul 16, 2020 (3 updates tracked since 2020).

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About Kellie Jasmine Blank Pa-c NPPES

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

KELLIE JASMINE BLANK PA-C (NPI 1659989630) is an individual physician assistant in Wyandotte, Michigan, licensed in Michigan (5601011698) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS, is affiliated with University Of Michigan Health System, and maintains a secondary practice location in Ann Arbor.

NPPES Registry Identity

NPI1659989630

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLIE JASMINE BLANKCredential: PA-C

Location Address2333 BIDDLE AVEWyandotte, MI 48192-4668

Mailing Address3621 S State StAnn Arbor, MI 48108-1633 · (734) 647-5299

Phone(734) 246-6000

Sole ProprietorNo

Medical School CMSPennsylvania State University College Of MedicineGraduated 2020

Enumeration DateJuly 16, 2020

Last NPPES UpdateSeptember 22, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 22, 2025

✔ NPI 1659989630 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 MI · 5601011698

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.

2333 BIDDLE AVE, Wyandotte, MI 48192

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Secondary Practice Location 1

Location 11500 E Medical Center DrAnn Arbor, MI 48109-5000 · Phone (734) 936-4000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community 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

Kellie Jasmine Blank Pa-c 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 ID5597185389

PECOS Enrollment IDI20230811002772

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 2

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.

26 services21 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

25 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Michigan Health System

Acute Care Hospitals · Ann Arbor, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230046

Location1500 E Medical Center Drive, Spc 5474Ann Arbor, MI 48109 · Washtenaw County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48192 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$72.38 typical visit price

range $18.32 – $143.49

Typical copayment $18.09 (range $4.58 – $35.87)

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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221

DME-Other DME · category DE017N

1 supplier19 claims19 services$18.47 avg. paid by Medicare

Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222

DME-Medical/Surgical Supplies · category DA000N

1 supplier19 claims19 services$35.96 avg. paid by Medicare

Injection, fluorouracil, 500 mg J9190

Treatment-Chemotherapy · category RH002N

1 supplier19 claims188 services$1.58 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

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