Gregary M Blackner, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00026210 Issued in WA

Practice address

1617 Summit Lake Shore Rd NW
Olympia, WA 98502-9437

Phone

(801) 682-8190

Fax

(801) 214-1875

NPI assigned

Aug 17, 2006

Last updated

May 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

University of Washington School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Olympia Orthopaedic Associates PLLCGroup PAC ID 2365337508, 87 clinicians

Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.86 of 100Reported as group

Quality

75.41

Promoting interoperability

100

Improvement activities

40

Cost

87.45

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gregary.blackner.1@5512.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/5512/brand/1/csg/1/fhir/r4

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment Care Compare group NPD
• Olympia Orthopaedic Associates PLLC

  dba Centralia Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Olympia, WA
  • NPI 1083785398
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1669619870

  Family Medicine

  NPD
• Olympia Orthopaedic Associates, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Centralia, WA
  • NPI 1134089576
  NPD

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1316050602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 721",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840370721",
            "telephone_number": "801-682-8190",
            "fax_number": "801-214-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 SUMMIT LAKE SHORE RD NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985029437",
            "telephone_number": "801-682-8190",
            "fax_number": "801-214-1875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Lilly Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065115",
            "country_code": "US",
            "telephone_number": "360-923-7000",
            "fax_number": "360-923-7089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKNER",
        "first_name": "GREGARY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00026210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8455420",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "201 16th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1617 Summit Lake Shore Rd NW",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985029437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Morgan Celeste Black
• Marles Blackbird, LMT
• Montana N Blackley, CRNA
• Wendy Blackman, DNP, ARNP, CPNP-PC
• Kevin Blackmon, MD
• Abigail Blackwell, NP-C
• Amanda Blades-Serrao
• April Blair, RN
• Lillie Blair
• Kelli Jo Blaise, RN

• Family Medicine Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.