Blake J. Beck, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA61261831 Issued in WA

Practice address

510 8TH Ave NE Ste 310
Issaquah, WA 98029-5436

Phone

(425) 462-5006

Fax

(425) 462-5019

NPI assigned

May 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, WA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bbeck548626@hisp.ehr.sutterhealth.org
• Direct secure messaging: blake.beck.p79@direct.proliance.nextgenshare.com
• Direct secure messaging: bbeck2156733@ghc.direct-ci.net

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.

• Associated Emergency Room Physicians, Inc P.S.

  • Emergency Medicine Physician
  • Renton, WA
  • NPI 1861480840
  Medicare reassignment
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment
• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment
• Physician Assistant Surgical Assist, Inc

  • Surgery Physician
  • Rocklin, CA
  • NPI 1093059248
  Medicare reassignment
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1124264577
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463

  Surgical

  NPD
• Proliance Surgeons, Inc., P.S.

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Issaquah, WA
  • NPI 1073768719
  NPD
• Virginia Mason Medical Center

  • Emergency Medicine Physician
  • Seattle, WA
  • NPI 1780748657
  NPD
• Virginia Mason Medical Center

  • Interventional Cardiology Physician
  • Tacoma, WA
  • NPI 1821711953
  NPD

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1104483783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 310",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-462-5006",
            "fax_number": "425-462-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 310",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-462-5006",
            "fax_number": "425-462-5019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1231 116th Ave NE Ste 915",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980043822",
            "country_code": "US",
            "telephone_number": "425-454-3938",
            "fax_number": "425-454-2568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECK",
        "first_name": "BLAKE",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56794",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61261831",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61261831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2212954",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Lance Baugh, LICSW
• Erica Bayot, MSW, LSWAIC
• BC Issaquah MC, LLC Dba Ciel Senior Living of Issaquah
• Janice Darlene Beattie, M.S.
• Alison M Beaudry, DPT
• Alexandria Becker, PA-C
• Amanda Becker
• Kerry Esther Becklund, OT
• Jeffrey Beers, MD
• Rino Beh

• Surgical Physician Assistant in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.