Individual provider Active NPI

Hailey Blizniak

  • Family Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1114410420
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60879548 Issued in WA
Practice address
602 E Nob Hill Blvd
Yakima, WA 98901-3534
Phone
(509) 248-3334
Fax
(509) 453-6144
NPI assigned
Jun 11, 2018
Last updated
Mar 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60879548 WA Primary
Registered Nurse 163W00000X 60767082 WA

Addresses

Primary practice location

602 E Nob Hill Blvd
Yakima, WA 98901-3534

Mailing address

602 E Nob Hill Blvd
Yakima, WA 98901-3534
Phone (509) 248-3334

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hblizniak27255@yvfwc.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20200117000759 WA Practitioner - Nurse Practitioner 5799110854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Farm Workers ClinicGroup PAC ID 4385541986, 274 clinicians

Practice addresses (Care Compare)

602 E Nob Hill Blvd
Yakima, WA 98901-3534
Phone (509) 248-3334

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
60767082WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic Current Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Oct 16, 2019 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Oct 16, 2019 Accepting new patients

Locations

2205 W Lincoln Ave
Yakima, WA 98902
Phone (509) 469-6305

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

602 E Nob Hill Blvd
Yakima, WA 98901
Phone (509) 248-3334

Organizations & group practices 3

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 2

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1114410420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 E NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013534",
            "telephone_number": "509-248-3334",
            "fax_number": "509-453-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013534",
            "telephone_number": "509-248-3334",
            "fax_number": "509-453-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLIZNIAK",
        "first_name": "HAILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60879548",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "60767082",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hblizniak27255@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "602 E Nob Hill Blvd",
            "city": "Yakima",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989013534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.