Individual provider Active NPI

Daniel Adam Blasch, PA-C

  • Physician Assistant
  • Hastings, MI
National Provider Identifier
1043851132
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009568 Issued in MI
Practice address
840 Cook Rd
Hastings, MI 49058-9616
Phone
(269) 945-9520
NPI assigned
Oct 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601009568 MI Primary

Addresses

Primary practice location

840 Cook Rd
Hastings, MI 49058-9616

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dblasch251661@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191118001619 MI Practitioner - Physician Assistant 8729410451 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pennock HospitalGroup PAC ID 4587551015, 79 clinicians

Practice addresses (Care Compare)

1005 W Green St
Hastings, MI 49058-1725

1009 W Green St
Corewell Health Pennock Hospital
Hastings, MI 49058-1710
Phone (269) 948-3129

840 Cook Rd
Hastings, MI 49058-9616
Phone (269) 945-9520

Hospital & facility affiliations

  • Corewell Health Pennock Hospital Hospital, Hastings, MI, CCN 231339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Current Accepting new patients
Pennock Hospital CurrentSince Nov 30, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Mar 19, 2020 Accepting new patients
Pennock Hospital CurrentSince Nov 30, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Mar 19, 2020 Accepting new patients

Locations

9090 S Rodgers Ct SE
Ste A
Caledonia, MI 49316
Phone (616) 891-0422

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

840 Cook Rd
Hastings, MI 49058
Phone (269) 945-4966

1005 W Green St
Ste 300
Hastings, MI 49058
Phone (269) 948-8411

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: dblasch251661@epic00.corewelldirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1043851132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 COOK RD",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490589616",
            "telephone_number": "269-945-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASCH",
        "first_name": "DANIEL",
        "middle_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-01",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dblasch251661@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "840 Cook Rd",
            "city": "Hastings",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490589616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "840 Cook Rd",
            "city": "Hastings",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490589616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hastings, MI

Sources for this page

Verify at the official NPI Registry.