Individual provider Active NPI

Gregory Scott Blaschke, MD, MPH

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1255308896
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
GFE 068252 Issued in CA
Practice address
34800 Bob Wilson Dr
Nmcsd, Attn: Medical Staff Services
San Diego, CA 92134-1098
Phone
(619) 532-6460
Fax
(619) 532-6299
NPI assigned
Mar 2, 2006
Last updated
Oct 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 31640-020 WI
Pediatrics Physician 208000000X GFE 068252 CA Primary

Addresses

Primary practice location

34800 Bob Wilson Dr
Nmcsd, Attn: Medical Staff Services
San Diego, CA 92134-1098

Mailing address

34800 Bob Wilson Dr
Nmcsd, Attn: Medical Staff Services
San Diego, CA 92134-1098
Phone (619) 532-6460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20090924000684 OR Practitioner - Pediatric Medicine 9638225121 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GFE 068252CAMDPediatrics Physician
31640-020WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Oct 1, 2009 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Oct 1, 2009 Accepting new patients
Oregon Health & Science University Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

Interoperability endpoints

  • Direct secure messaging: gblaschkemd36510@direct.ohsu.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1255308896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "NMCSD, ATTN: MEDICAL STAFF SERVICES",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-6460",
            "fax_number": "619-532-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "NMCSD, ATTN: MEDICAL STAFF SERVICES",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-6460",
            "fax_number": "619-532-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASCHKE",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "31640-020",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "GFE 068252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.