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

Kelly Jo Bleakley, PA-C

Individual provider Physician Assistant · NPI 1124676580

Kelly Jo Bleakley, PA-C is a Physician Assistant in Vero Beach, Florida. Qualified in 2019, 7 years ago. Practices with Indian River Health Services Inc, a 332-clinician group and accepts Medicare assignment. Licensed in Florida, Georgia and New York.

Years since qualifying
7
Licensed in
FL, GA, NY
In the registry since
2019
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3450 11th Ct Ste 105
Vero Beach, FL 32960-5012
Phone: (772) 778-3680
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9117749 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 9269 (GA)
Physician Assistant Taxonomy 363A00000X · Licence 025755 (NY)

Record details

NPI number1124676580
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 29, 2019
Last updated in NPPESJune 8, 2025
Certification dateJune 8, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Indian River Health Services Inc — 332 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Vero Beach