Sandra Gautier Blackman, PA-C is a medicare enrolled "Physician Assistant" physician in Tampa, Florida. She graduated from medical school in 2021 and has 4 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc and her current practice location is
12902 Usf Magnolia Dr, Tampa, Florida. You can reach out to her office (for appointments etc.) via phone at
(813) 745-4673.
Sandra Gautier Blackman is licensed to practice in Florida (license number PA9114259) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1710551478.
Physician's Profile
| Full Name | Sandra Gautier Blackman |
|---|
| Gender | Female |
|---|
| Speciality | Physician Assistant |
|---|
| Experience | 4 Years |
|---|
| Location | 12902 Usf Magnolia Dr, Tampa, Florida |
|---|
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Sandra Gautier Blackman graduated from medical school in 2021
NPI Data:
- NPI Number: 1710551478
- Provider Enumeration Date: 05/18/2021
- Last Update Date: 09/19/2025
Medicare PECOS Information:
- PECOS PAC ID: 0143621623
- Enrollment ID: I20210622003479
Medical Identifiers
Medical identifiers for Sandra Gautier Blackman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710551478 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2086X0206X | Surgery - Surgical Oncology | PA9114259 (Florida) | Secondary |
| 363A00000X | Physician Assistant | PA9114259 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc | 2264337021 | 1045 |
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. Sandra Gautier Blackman 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 |
|---|
Sandra Gautier Blackman, PA-C
Po Box 198441,
Atlanta, GA 30384-8441
Ph: (813) 745-4673 | Sandra Gautier Blackman, PA-C
12902 Usf Magnolia Dr,
Tampa, FL 33612-9416
Ph: (813) 745-4673 |
Reviews and Comments