Steven Michael Blizzard, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11136 Issued in CA

Practice address

7777 Sunrise Blvd
Suite 2500
Citrus Heights, CA 95610-2300

Phone

(916) 722-2227

Fax

(877) 860-5422

NPI assigned

Dec 8, 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 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Molina Healthcare of California

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  NPD (past)
• Molina Healthcare of California

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1841305075
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1497814115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 FAIR OAKS AVE STE 270",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910305801",
            "telephone_number": "626-346-2455",
            "fax_number": "626-639-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 SUNRISE BLVD",
            "address_2": "SUITE 2500",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956102300",
            "telephone_number": "916-722-2227",
            "fax_number": "877-860-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLIZZARD",
        "first_name": "STEVEN",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA11136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01453363-DV5277",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF:02/20/13-NORWOOD",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF:2/20/13-MARYSVIL",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF:3/22/13-55THST",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF: 3/22/13-CITRUSH",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Citrus Heights, CA
• Providers in Citrus Heights, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.