Individual provider Active NPI

Blaise S Pfaffmann, AUD

  • Audiologist
  • San Diego, CA
National Provider Identifier
1285135749
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
3693 Issued in CA
Practice address
2815 Camino del Rio S Ste 220
San Diego, CA 92108-3817
Phone
(858) 279-6772
NPI assigned
Feb 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 31008 OR
Assistive Technology Practitioner Audiologist 231HA2400X
Assistive Technology Supplier Audiologist 231HA2500X
Audiologist-Hearing Aid Fitter 237600000X
Audiologist 231H00000X 3693 CA Primary

Addresses

Primary practice location

2815 Camino del Rio S Ste 220
San Diego, CA 92108-3817

Mailing address

2815 Camino del Rio S Ste 220
San Diego, CA 92108-3817
Phone (858) 279-6772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230127002751 CA Practitioner - Qualified Audiologist 0446621536 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31008ORMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital of Orange County CurrentSince Sep 3, 2022 Accepting new patients
Pediatric Subspecialty Faculty, Inc. Past Accepting new patients
Griffin Center PastSince Sep 1, 2021 Accepting new patients
Neurodynamics Inc Audiologist PastSince May 28, 2023 Accepting new patients
Audioscope Audiology Group Apc Audiologist PastSince May 28, 2023 Accepting new patients

Locations

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Dept LA 21333
Pasadena, CA 91185

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1285135749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 CAMINO DEL RIO S STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083817",
            "telephone_number": "858-279-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 CAMINO DEL RIO S STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083817",
            "telephone_number": "858-279-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFAFFMANN",
        "first_name": "BLAISE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-21",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "31008",
            "primary": false
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "3693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.