Active NPI
Jason Blanks
- Neonatal-Perinatal Medicine Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- MD215444
- Practice address
- 3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011 - Phone
- (503) 494-8122
- Fax
- (503) 494-1542
- NPI assigned
- Nov 19, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD215444 | OR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neonatal-Perinatal Medicine Physician | 2080N0001X | MD215444 | OR | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Mailing address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8122
Other practice location 1
4610 X St
Sacramento, CA 95817-2200
Phone (916) 214-6805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD215444 | OR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tuality Medical Group LLC | Current | Accepting new patients | |
| Portland Adventist Medical Center | Current | Accepting new patients | |
| Tuality Medical Group LLC | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| Portland Adventist Medical Center | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880
335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111
10123 SE Market St
Portland, OR 97216
Phone (503) 251-6355
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
Interoperability endpoints
- jblanks122621@direct.ohsu.edu
Organizations & group practices 7
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.
-
- Family Medicine Physician
- Portland, OR
- NPI 1750091021
-
- Internal Medicine Physician
- Hillsboro, OR
- NPI 1073929782
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- Anesthesiology Physician
- Portland, OR
- NPI 1437925310
-
- Neurology Physician
- Hillsboro, OR
- NPI 1639690704
-
- Pharmacy
- Beaverton, OR
- NPI 1073054714
-
- Adult Mental Health Clinic/Center
- Portland, OR
- NPI 1750753687
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689120000000",
"number": "1497224513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-8122",
"fax_number": "503-494-1542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-8122",
"fax_number": "503-494-1542"
}
],
"practiceLocations": [
{
"address_1": "4610 X St",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958172200",
"country_code": "US",
"telephone_number": "916-214-6805",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLANKS",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-19",
"last_updated": "2023-07-12",
"certification_date": "2023-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD215444",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "OR",
"license": "MD215444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.