Individual provider Active NPI

Byron Blasko, ARNP

  • Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1396791133
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 1554842 Issued in FL
Practice address
1300 Medical Dr
Tallahassee, FL 32308-4646
Phone
(850) 216-0100
Fax
(850) 216-0112
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 1554842 FL
Nurse Practitioner 363L00000X ARNP 1554842 FL Primary

Addresses

Primary practice location

1300 Medical Dr
Tallahassee, FL 32308-4646

Mailing address

1300 Medical Dr
Tallahassee, FL 32308-4646
Phone (850) 216-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061219000482 FL Practitioner - Nurse Practitioner 8426057522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Memorial Healthcare IncGroup PAC ID 6103724778, 498 clinicians

Practice addresses (Care Compare)

1300 Medical Dr
Tallahassee, FL 32308-4646
Phone (850) 216-0100

Hospital & facility affiliations

  • Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1554842FLMDUrology Physician
ARNP 1554842FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc CurrentSince Jul 14, 2012 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Jul 14, 2012 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Southern Medical Group, PA Past Accepting new patients

Locations

15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105

1609 Physicians Dr
Tallahassee, FL 32308
Phone (850) 431-4243

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1300 Medical Dr
Tallahassee, FL 32308
Phone (850) 216-0190

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

Interoperability endpoints

  • Direct secure messaging: byronblasko@tmhpp2.allscriptsdirect.net
  • Direct secure messaging: bblasko21475@tallahasseememorial.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1396791133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MEDICAL DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084646",
            "telephone_number": "850-216-0100",
            "fax_number": "850-216-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MEDICAL DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084646",
            "telephone_number": "850-216-0100",
            "fax_number": "850-216-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASKO",
        "first_name": "BYRON",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "1554842",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 1554842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.