Bruce Robert Blazar, M.D.

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

25330 Issued in MN

Practice address

516 Delaware Street SE
University of MN Physicians, PWB Fifth Floor, Clinic 5B
Minneapolis, MN 55455

Phone

(612) 273-2800

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 14

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bblazar147994@fairview.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• University of Minnesota Health Clinics and Surgery Center, Inc.

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1053795187
  Medicare reassignment NPD
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment NPD
• Fairview Express Care

  • Specialist
  • Saint Paul, MN
  • NPI 1679048763
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• University of Minnesota Health Clinics and Surgery Center Inc

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1003485004
  NPD
• University of Minnesota Pediatric Dental Clinic

  • Dentist
  • Minneapolis, MN
  • NPI 1992075287
  NPD
• University of Minnesota Physicians

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1003842162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE STREET SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS, MMC 109",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-2961",
            "fax_number": "612-626-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 DELAWARE STREET SE",
            "address_2": "UNIVERSITY OF MN PHYSICIANS, PWB FIFTH FLOOR, CLINIC 5B",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-273-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZAR",
        "first_name": "BRUCE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "25330",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MN",
            "license": "25330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1008985",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2086719301",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30695100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "761878600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7777470",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1986259",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "132947",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0243838",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10387",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "768027",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052326",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "12-24756",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY",
            "identifier": "12-70281",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP21976",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joelle Blasig, PHARMD
• John Blaska, L.AC.
• Elizabeth Blattner
• Julie Blatz, MSW, LICSW
• Teri Blauersouth, M.A.
• Claire Blaze
• Jennifer Bleakmore, OTR/L
• William Bleifuss, MD
• Parker Bryan Blekkenk, MD
• Kathleen Blesi, RN

• Pediatric Hematology & Oncology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pediatric Hematology & Oncology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.