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

Mr. Blake Edward Sidleck, PA

Individual provider Physician Assistant · NPI 1831088343

Mr. Blake Edward Sidleck, PA is a Physician Assistant in Atlanta, Georgia. Graduated from Philadelphia Col of Osteo Med, Sewanee in 2025, 1 year ago. Registered with an NPI since 2025.

Years since qualifying
1
Trained at
Philadelphia Col of Osteo Med, Sewanee
In the registry since
2025
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

550 Peachtree St NE Ste 1700
Atlanta, GA 30308-2262
Phone: (484) 951-3217
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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 number1831088343
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 30, 2025
Last updated in NPPESJune 30, 2025
Certification dateJune 30, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolPHILADELPHIA COL OF OSTEO MED, SEWANEE
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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