Individual provider Active NPI

Blake Richard Lambourne, MEDICAL DOCTOR

  • Obstetrics & Gynecology Physician
  • Roseville, CA
National Provider Identifier
1194793802
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G83649 Issued in CA
Practice address
5 Medical Plaza Dr
Suite 250
Roseville, CA 95661-2868
Phone
(916) 782-2229
Fax
(916) 797-9414
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G83649 CA Primary

Addresses

Primary practice location

5 Medical Plaza Dr
Suite 250
Roseville, CA 95661-2868

Mailing address

5Medical Plaza Dr
Suite 250
Roseville, CA 95661-2868
Phone (916) 782-2229

Other identifiers 1

IdentifierTypeStateIssuer
00G836490MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081204000060 CA Practitioner - Obstetrics/Gynecology 3173696333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.59 of 100Reported as group
Quality
98.41
Promoting interoperability
100
Improvement activities
40
Cost
73.54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G83649CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: blambourne35497@hisp.ehr.sutterhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1194793802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5MEDICAL PLAZA DR",
            "address_2": "SUITE 250",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612868",
            "telephone_number": "916-782-2229",
            "fax_number": "916-797-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PLAZA DR",
            "address_2": "SUITE 250",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612868",
            "telephone_number": "916-782-2229",
            "fax_number": "916-797-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBOURNE",
        "first_name": "BLAKE",
        "middle_name": "RICHARD",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G83649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G836490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.