Jonathan James Blaza, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

66669-20 Issued in WI

Practice address

1250 W National Rd Ste 400
Englewood, OH 45315

Phone

(937) 832-3300

NPI assigned

Apr 6, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
• Kettering Homecare Home health agency, Kettering, OH, CCN 367778
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Kettering Health Troy Hospital, Troy, OH, CCN 360368
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Alliance Physicians Inc

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment Care Compare group NPD

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

• Alternate Solutions Homecare of Dayton, LLC

  • Home Health Agency
  • Kettering, OH
  • NPI 1639195332
  Care Compare affiliation
• Dayton Osteopathic Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Fidelity Health Care Inc

  • Home Health Agency
  • Moraine, OH
  • NPI 1235127838
  Care Compare affiliation
• Kettering Medical Center

  • General Acute Care Hospital
  • Troy, OH
  • NPI 1023587045
  Care Compare affiliation
• Kettering Medical Center

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Kettering Medical Center

  • General Acute Care Hospital
  • Miamisburg, OH
  • NPI 1316966518
  Care Compare affiliation
• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1245625359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W NATIONAL RD STE 400",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453159506",
            "telephone_number": "937-836-6000",
            "fax_number": "937-832-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W NATIONAL RD STE 400",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "45315",
            "telephone_number": "937-832-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 250",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532153678",
            "country_code": "US",
            "telephone_number": "414-649-7909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAZA",
        "first_name": "JONATHAN",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "66669-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0310911",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jblaza524755@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "1250 W National Rd Ste 400",
            "city": "Englewood",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1250 W National Rd Ste 400",
            "city": "Englewood",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Asabe Biri
• Aiyana Blackburn
• John L Blackstone
• Carol L Bland, MD
• Joshua Blanton
• Trevor Daniel Bluemel, MD
• Elizabeth Ann Bockey, RPH
• Alessandra Isabella Bonanno, PA-C
• Alyssa Bosse, RDN
• Olivia Bradley, PHARMD

• Family Medicine Physician in Englewood, OH
• Providers in Englewood, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.

Verify at the official NPI Registry.