Active NPI
Blain A Crandell, MD
- Family Medicine Physician
- Bainbridge Island, WA
National Provider Identifier
1215964614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00043807
- Practice address
- 123 Bjune Dr SE
Suite 101
Bainbridge Island, WA 98110-2459 - Phone
- (206) 842-3222
- Fax
- (206) 842-1877
- NPI assigned
- Jun 28, 2006
- Last updated
- Dec 2, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00043807 | WA | Primary |
Addresses
Primary practice location
123 Bjune Dr SE
Suite 101
Bainbridge Island, WA 98110-2459
Mailing address
123 Bjune Dr SE
Suite 101
Bainbridge Island, WA 98110-2459
Phone (206) 842-3222
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0284290 | Other | WA | DEPT OF LABOR AND INDUSTRIES |
| 8399065 | Medicaid | WA | |
| P00974408 | Other | WA | RAILROAD MEDICARE |
| 0186660 | Other | WA | LABOR & INDUSTRIES |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Alabama School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Select Outpatient Services Inc
Practice addresses (Care Compare)
123 Bjune Dr SE
Suite 101
Bainbridge Island, WA 98110-2459
Phone (206) 842-3222
2600 Compass Rd
Glenview, IL 60026-8001
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 37 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Member Plus Family Health PLLC | Family Medicine | Current | Accepting new patients |
| Family Health Centers | Past | Accepting new patients |
Locations
123 Bjune Dr SE
Ste 101
Bainbridge Island, WA 98110
Phone (206) 842-3222
Interoperability endpoints
- blain.crandell@91917277134852.direct.elationemr.com
- blain.crandell@direct.vmmc.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Bainbridge Island, WA
- NPI 1447740998
-
- Rehabilitation Clinic/Center
- Glenview, IL
- NPI 1346368248
-
- Federally Qualified Health Center (FQHC)
- Okanogan, WA
- NPI 1609804392
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CenterWell Home Health
- Home Health Agency
- Silverdale, WA
- NPI 1114958725
-
dba St Michael Medical Center
- General Acute Care Hospital
- Silverdale, WA
- NPI 1518912609
-
- Home Health Agency
- Silverdale, WA
- NPI 1902369606
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1306992151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385942400000",
"number": "1215964614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 BJUNE DR SE",
"address_2": "SUITE 101",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981102459",
"telephone_number": "206-842-3222",
"fax_number": "206-842-1877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 BJUNE DR SE",
"address_2": "SUITE 101",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981102459",
"telephone_number": "206-842-3222",
"fax_number": "206-842-1877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDELL",
"first_name": "BLAIN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2013-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00043807",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR AND INDUSTRIES",
"identifier": "0284290",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8399065",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00974408",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0186660",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bainbridge Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.