Individual provider Active NPI

Brooke Christine Blaser, PA-C

  • Physician Assistant
  • National City, CA
National Provider Identifier
1265903868
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA56334 Issued in CA
Practice address
502 Euclid Ave Ste 204
National City, CA 91950-2949
Phone
(619) 765-2684
NPI assigned
Dec 8, 2018
Last updated
Aug 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA56334 CA Primary

Addresses

Primary practice location

502 Euclid Ave Ste 204
National City, CA 91950-2949

Mailing address

29911 Niguel Road
PO Box 7312
Laguna Niguel, CA 92607-9998

Other practice location 1

6496 Weathers Pl Ste 100
San Diego, CA 92121-2936
Phone (858) 925-6137

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190424000968 CA Practitioner - Physician Assistant 2062754930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
56334CAMDPharmacist
PA56334CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Regents of the University of California Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1544227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1265903868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29911 NIGUEL ROAD",
            "address_2": "PO BOX 7312",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926079998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 204",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502949",
            "telephone_number": "619-765-2684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6496 Weathers Pl Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921212936",
            "country_code": "US",
            "telephone_number": "858-925-6137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLASER",
        "first_name": "BROOKE",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-08",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.