NPIMap

Individual provider Active NPI

Joseph Blahut, PA-C

  • Physician Assistant
  • Naperville, IL
National Provider Identifier
1083779342
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085002613 Issued in IL
Practice address
4 South 100 Route 59
Unit 6
Naperville, IL 60563-9697
Phone
(630) 416-8289
Fax
(630) 416-8306
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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 085002613 IL Primary

Addresses

Primary practice location

4 South 100 Route 59
Unit 6
Naperville, IL 60563-9697

Mailing address

4 South 100 Route 59
Unit 6
Naperville, IL 60563-9697
Phone (630) 416-8289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085002613ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atkinson Chiropractic and Acupuncture SC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1083779342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SOUTH 100 ROUTE 59",
            "address_2": "UNIT 6",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639697",
            "telephone_number": "630-416-8289",
            "fax_number": "630-416-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SOUTH 100 ROUTE 59",
            "address_2": "UNIT 6",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639697",
            "telephone_number": "630-416-8289",
            "fax_number": "630-416-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAHUT",
        "first_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.