Milton Louis Blettel, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD15147 Issued in OR

Practice address

9900 SW Hall Blvd
#200
Tigard, OR 97223

Phone

(503) 293-1515

Fax

(503) 595-3905

NPI assigned

Dec 6, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 13, 2014 through May 13, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Advantage Medical Group LLP

  • Internal Medicine Physician
  • Tigard, OR
  • NPI 1578633616
  NPD (past)
• East Portland Medical Associates LLC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1922285238
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336208388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 SW HALL BLVD",
            "address_2": "#200",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-293-1515",
            "fax_number": "503-595-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 SW HALL BLVD",
            "address_2": "#200",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-293-1515",
            "fax_number": "503-595-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLETTEL",
        "first_name": "MILTON",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD15147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078444",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Travis Blake Jr.
• Robin C. Blakeslee Smith, LMT
• Holly Blalack
• Mary Louise Blankenship, RN, FNP, PMHNP-BC
• Allison Claire Blaskowsky, M.S., CF-SLP
• Phoenix Horton-Holmes Blickle, R.N.
• Jerrold P Blocher, PHARMD
• Monica Heather Bloom, LPCA
• Blue Ocean Care LLC
• Dana Lynn Boddy, CRM

• Internal Medicine Physician in Tigard, OR
• Providers in Tigard, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.