MR. BLAKE EDWARD SIDLECK PA
NPI 1831088343
Physician Assistant in Atlanta, GA

Q: What is Blake Sidleck's NPI number?

The NPI number for Blake Sidleck is 1831088343. It was assigned to this individual provider in the NPPES registry on June 30, 2025.

Q: What is Blake Sidleck'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 Blake Sidleck was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 June 30, 2025PECOS Enrolled

550 PEACHTREE ST NE STE 1700, ATLANTA, GA 30308(484) 951-3217 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Blake Edward Sidleck Pa NPPES

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

MR. BLAKE EDWARD SIDLECK PA (NPI 1831088343) is an individual physician assistant in Atlanta, Georgia and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS, is affiliated with Emory University Hospital Midtown, and is a graduate of Philadelphia Col Of Osteo Med, Sewanee (2025).

NPPES Registry Identity

NPI1831088343

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. BLAKE EDWARD SIDLECKCredential: PA

Location Address550 PEACHTREE ST NE STE 1700Atlanta, GA 30308-2262

Mailing Address5479 Glenridge Dr Apt 4404Atlanta, GA 30342-1340 · (484) 951-3217

Phone(484) 951-3217

Sole ProprietorNo

Medical School CMSPhiladelphia Col Of Osteo Med, SewaneeGraduated 2025

Enumeration DateJune 30, 2025

NPPES CertifiedJune 30, 2025

✔ NPI 1831088343 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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.

550 PEACHTREE ST NE STE 1700, Atlanta, GA 30308

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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)

Mr. Blake Edward Sidleck Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5193221695

PECOS Enrollment IDI20251003000056

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.

Hospital Affiliations CMS Care Compare

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

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110078

Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30308 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

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.

Other Providers at the Same Location NPPES 7

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

KC PROCEDURES LLC

Internal Medicine (Gastroenterology)