Individual provider Active NPI

Blake Michael Marlia, DPT

  • Physical Therapist
  • Baker City, OR
National Provider Identifier
1346265253
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4182 Issued in OR
Practice address
3950 17TH St Ste B
Baker City, OR 97814-1300
Phone
(541) 523-8888
Fax
(541) 523-8889
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4182 OR Primary

Addresses

Primary practice location

3950 17TH St Ste B
Baker City, OR 97814-1300

Mailing address

3950 17TH St Ste B
Baker City, OR 97814-1300
Phone (541) 523-8888

Other identifiers 2

IdentifierTypeStateIssuer
228760MedicaidOR
P00245147OtherORRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819000650 OR Practitioner - Physical Therapist in Private Practice 8325172828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as group
Quality
85.59
Improvement activities
40
Cost
83.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4182ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert J Bachman P T PC Physical Therapist CurrentSince Jun 18, 2001 Accepting new patients

Locations

3950 17th St
Ste B
Baker City, OR 97814
Phone (541) 523-8888

Organizations & group practices 1

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1346265253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 17TH ST STE B",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141300",
            "telephone_number": "541-523-8888",
            "fax_number": "541-523-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 17TH ST STE B",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141300",
            "telephone_number": "541-523-8888",
            "fax_number": "541-523-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLIA",
        "first_name": "BLAKE",
        "middle_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228760",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00245147",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baker City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.