Natalie Marie Blaskowski, PA-C

Individual provider Active NPI Physician Assistant · Park City, UT

NPI 1124589262 · NPPES record last updated Nov 17, 2020

Key facts

NPI
1124589262
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
11504426-1206 (UT)
Practice address
900 Round Valley Dr Ste 100
Park City, UT 84060-7552
Phone
(435) 656-6600
NPI assigned
Mar 30, 2019
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosenberg Cooley Metcalf LC (35 clinicians)

Practice addresses (Care Compare)

6340 S 3000
Suite 200
Salt Lake City, UT 84121-3552
Phone (435) 655-6600

900 Round Valley Dr
Suite 100
Park City, UT 84060-7552
Phone (435) 655-6600

Hospital & facility affiliations

  • Park City Hospital Hospital · Park City, UT · CCN 460057

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200103000559 UT Practitioner - Physician Assistant 0042644833 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11504426-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rosenberg Cooley Metcalf LC Orthopaedic Surgery Current
since Oct 28, 2019
Accepting new patients

Locations

900 Round Valley Dr
Ste 100
Park City, UT 84060
Phone (435) 655-6600

6340 S 3000 E
Ste 200
Salt Lake City, UT 84121
Phone (435) 655-6600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJFECD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 11504426-1206 UT Yes

Addresses

Primary practice location

900 Round Valley Dr Ste 100
Park City, UT 84060-7552

Mailing address

900 Round Valley Dr Ste 100
Park City, UT 84060-7552
Phone (435) 656-6600

Other names

  • Natalie Marie Plascencia Former name

Other providers in Park City, UT

All providers in Park City, UT · Physician Assistant in Utah

Sources for this page

Verify at the official NPI Registry.