Pavel S. Blagov, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60236271 Issued in WA

Practice address

409 E Sumach St
Ste 3
Walla Walla, WA 99362-1202

Phone

(509) 876-1793

Fax

(877) 991-1631

NPI assigned

Mar 20, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Insight Psychology, PLLC

  • Clinical Psychologist
  • Walla Walla, WA
  • NPI 1558863993

  WA

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537574400000",
    "number": "1346515541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 HEDINE RD",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993628716",
            "telephone_number": "509-876-1793",
            "fax_number": "877-991-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E SUMACH ST",
            "address_2": "STE 3",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621202",
            "telephone_number": "509-876-1793",
            "fax_number": "877-991-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAGOV",
        "first_name": "PAVEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2018-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60236271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert A Billingsley, MD
• Whitney Marie Billingsley, LMP
• Oliver Birchwood-Glover, LCSW
• Thomas E Blackman, RN
• John Timothy Blackwelder, M.D.
• Kristina Renee Blake
• Barbara Ann Blankenship, M.D.
• Jeral Lee Ann Blankenship
• Sarah R. Blattler, LMP
• Karen Blood

• All providers in Walla Walla, WA
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2018; 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.