Lynnette Raye Blostica, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004446 Issued in MI

Practice address

3412 W Centre Ave
Portage, MI 49024-4624

Phone

(269) 329-5860

Fax

(269) 329-5865

NPI assigned

May 8, 2007

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kalamazoo Ophthalmology PCGroup PAC ID 8628112380, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.67 of 100Reported as group

Quality

100

Improvement activities

40

Cost

88.91

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lblostica@kopc.intellechartdirect.net

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

• Kalamazoo Ophthalmology PC

  • Ophthalmology Physician
  • Portage, MI
  • NPI 1467475723

  Optometrist

  Medicare reassignment Care Compare group NPD
• Norr Optical Inc

  • Eyewear Supplier
  • Portage, MI
  • NPI 1275665051
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1053524884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244624",
            "telephone_number": "269-329-5860",
            "fax_number": "269-329-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244624",
            "telephone_number": "269-329-5860",
            "fax_number": "269-329-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOSTICA",
        "first_name": "LYNNETTE",
        "middle_name": "RAYE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945215713",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lblostica@kopc.intellechartdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3412 W Centre Ave",
            "city": "Portage",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490244624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shantel Lynn Bleeker, PA-C, RD
• Lisa Carrie Block, LMSW-C
• Kimberly Blok
• Gloria Bloom
• Michael V Bloom, PHD
• Bluewater Counseling Services LLC
• Megan Bly, DPT, CLT
• Shiva Ram Boda
• Sneha Priya Boda
• Jacqueline A Boddy, MS, OT

• Optometrist in Portage, MI
• Providers in Portage, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.