Individual provider Active NPI

Natalie Marie Blaskowski, PA-C

  • Physician Assistant
  • Park City, UT
National Provider Identifier
1124589262
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11504426-1206 Issued in UT
Practice address
900 Round Valley Dr Ste 100
Park City, UT 84060-7552
Phone
(435) 656-6600
NPI assigned
Mar 30, 2019
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 2

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

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 1

  • Natalie Marie Plascencia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20200103000559 UT Practitioner - Physician Assistant 0042644833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosenberg Cooley Metcalf LCGroup PAC ID 0042291510, 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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rosenberg Cooley Metcalf LC Orthopaedic Surgery CurrentSince 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

Organizations & group practices 2

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 1

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": "1553904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1124589262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROUND VALLEY DR STE 100",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607552",
            "telephone_number": "435-656-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROUND VALLEY DR STE 100",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607552",
            "telephone_number": "435-656-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASKOWSKI",
        "first_name": "NATALIE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-30",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11504426-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATALIE",
            "last_name": "PLASCENCIA",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Park City, UT

Sources for this page

Verify at the official NPI Registry.