NPIMap

Individual provider Active NPI

Eliza Davis Blanchette, M.D.

  • Pediatric Nephrology Physician
  • Aurora, CO
National Provider Identifier
1063772929
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
DR.0062640 Issued in CO
Practice address
13123 E 16TH Ave # 328
Aurora, CO 80045-7106
Phone
(720) 777-7878
Fax
(720) 777-4592
NPI assigned
May 24, 2012
Last updated
Nov 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 62110-20 WI
Neonatal-Perinatal Medicine Physician 2080N0001X 62110-20 WI
Pediatric Nephrology Physician 2080P0210X DR.0062640 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave # 328
Aurora, CO 80045-7106

Mailing address

13123 E 16TH Ave # 328
Aurora, CO 80045-7106
Phone (720) 777-7878

Other names 1

  • Eliza Katherine Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191023002253 CO Practitioner - NephrologyPractitioner - Pediatric Medicine 5799006839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Pediatric Medicine
Education
Southern Illinois University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
62110-20WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Colorado Current Accepting new patients
University Physicians, Incorporated CurrentSince Sep 2, 2019 Accepting new patients
University Physicians Incorporated Pediatrics CurrentSince Sep 2, 2019 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

13123 E 16th Ave
#328
Aurora, CO 80045
Phone (720) 777-7878

Dept 1061
Denver, CO 80256

Interoperability endpoints

  • Direct secure messaging: eblanchette201516@direct.childrenscolorado.org

Organizations & group practices 4

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1063772929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE # 328",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-7878",
            "fax_number": "720-777-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE # 328",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-7878",
            "fax_number": "720-777-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHETTE",
        "first_name": "ELIZA",
        "middle_name": "DAVIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "62110-20",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WI",
            "license": "62110-20",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "CO",
            "license": "DR.0062640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZA",
            "last_name": "DAVIS",
            "middle_name": "KATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.