Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alice Marie Blackley, PA

Individual provider Physician Assistant · NPI 1124862669

Alice Marie Blackley, PA is a Physician Assistant in Lockport, New York. Qualified in 2024, 2 years ago. Practices with General Physician PC, a 487-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

5879 Snyder Dr
Lockport, NY 14094-9497
Phone: (716) 433-8751
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1124862669
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 20, 2024
Last updated in NPPESJune 20, 2024
Certification dateJune 20, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice General Physician Pc — 487 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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