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

Blake Bazzi

Individual provider Physician Assistant · NPI 1770276719

Blake Bazzi is a Physician Assistant in Oak Park, Michigan. Graduated from Wayne State University School of Medicine in 2023, 3 years ago. Practices with Southfield City Urgent Care PC, a 21-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
3
Trained at
Wayne State University School of Medicine
Licensed in
MI
In the registry since
2023

Practice location Address checks out

24661 Coolidge Hwy
Oak Park, MI 48237-1449
Phone: (248) 398-4000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601011771 (MI)

Record details

NPI number1770276719
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 26, 2023
Last updated in NPPESJune 27, 2024
Certification dateJune 27, 2024
Mailing address24661 Coolidge Hwy, Oak Park, MI 48237-1449

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2023 (3 years in practice)
Group practice Southfield City Urgent Care Pc — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Oak Park