Dr Blayne K Street, DO is a medicare enrolled "Pediatrics" physician in Sweetwater, Texas. He went to University Of North Texas Hsc, College Of Osteopathic Med and graduated in 2016 and has 8 years of diverse experience with area of expertise as Pediatric Medicine. He is a member of the group practice Discovery Medical Network Sweetwater Llc and his current practice location is
301 Jenny George Lane, Building B, Suite 5, Sweetwater, Texas. You can reach out to his office (for appointments etc.) via phone at
(325) 219-6175.
Dr Blayne K Street is licensed to practice in Texas (license number S6314) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1568811636.
Physician's Profile
| Full Name | Dr Blayne K Street |
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| Gender | Male |
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| Speciality | Pediatric Medicine |
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| Experience | 8 Years |
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| Location | 301 Jenny George Lane, Sweetwater, Texas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Blayne K Street attended and graduated from University Of North Texas Hsc, College Of Osteopathic Med in 2016
NPI Data:
- NPI Number: 1568811636
- Provider Enumeration Date: 06/08/2016
- Last Update Date: 06/13/2022
Medicare PECOS Information:
- PECOS PAC ID: 0042502809
- Enrollment ID: I20210726001959
Medical Identifiers
Medical identifiers for Dr Blayne K Street such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568811636 | NPI | - | NPPES |
| 426407901 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207QS0010X | Family Medicine - Sports Medicine | S6314 (Texas) | Secondary |
| 208000000X | Pediatrics | S6314 (Texas) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Discovery Medical Network Sweetwater Llc | 6608025176 | 7 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Blayne K Street allows following entities to bill medicare on his behalf.
| Entity Name | Discovery Medical Network Sweetwater Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134485550
PECOS PAC ID: 6608025176
Enrollment ID: O20120927000686 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Blayne K Street is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Blayne K Street, DO
301 Jenny George Ln, Building B, Suite 5,
Sweetwater, TX 79556-7152
Ph: (325) 219-6175 | Dr Blayne K Street, DO
301 Jenny George Lane, Building B, Suite 5,
Sweetwater, TX 79556
Ph: (325) 219-6175 |
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