NPIMap

Individual provider Active NPI

Michael Christopher Blose, PA-C

  • Medical Physician Assistant
  • Du Bois, PA
National Provider Identifier
1215418470
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA059947 Issued in PA
Practice address
100 Hospital Ave
Du Bois, PA 15801-1440
Phone
(814) 371-2200
NPI assigned
Aug 27, 2018
Last updated
Aug 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA059947 PA Primary

Addresses

Primary practice location

100 Hospital Ave
Du Bois, PA 15801-1440

Mailing address

211 Highland Ave
Punxsutawney, PA 15767-2415
Phone (814) 952-1347

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180925002334 PA Practitioner - Physician Assistant 9436400769 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians

Practice addresses (Care Compare)

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 371-2200

809 Turnpike Ave
Clearfield, PA 16830-1232
Phone (814) 765-5341

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center CurrentSince Sep 1, 2018 Accepting new patients
Elk Regional Health Center CurrentSince Sep 1, 2018 Accepting new patients
Elk Regional Health Center CurrentSince Sep 1, 2018 Accepting new patients
Dubois Regional Medical Center CurrentSince Sep 1, 2018 Accepting new patients
Clearfield Hospital Past Accepting new patients

Locations

809 Turnpike Ave
Clearfield, PA 16830
Phone (814) 765-5341

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

100 Hospital Ave
Ofc
Dubois, PA 15801

763 Johnsonburg Rd
Saint Marys, PA 15857
Phone (814) 788-8000

Organizations & group practices 6

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1215418470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 HIGHLAND AVE",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672415",
            "telephone_number": "814-952-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-371-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOSE",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA059947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.