NPIMap

Individual provider Active NPI

Tikoes A. Blankenberg, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Redding, CA
National Provider Identifier
1518022698
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
G56842 Issued in CA
Practice address
2036 Railroad Ave
Redding, CA 96001-1801
Phone
(530) 255-1000
Fax
(530) 247-8259
NPI assigned
Dec 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X G56842 CA Primary

Addresses

Primary practice location

2036 Railroad Ave
Redding, CA 96001-1801

Mailing address

2036 Railroad Ave
Redding, CA 96001-1801
Phone (530) 255-1000

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ58543ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080702000236 CA Practitioner - Pathology 5890697114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of California, Geffen School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redding PathologistsGroup PAC ID 6204738511, 5 clinicians

Practice addresses (Care Compare)

2036 Railroad Ave
Redding, CA 96001-1801
Phone (530) 255-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.36 of 100Reported as group
Quality
80
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G56842CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Redding Pathologists Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 1989 Accepting new patients
Nuclear Medicine Associates Current Accepting new patients
Shasta Regional Medical Center, LLC Past Accepting new patients
Catholic Healthcare West Past Accepting new patients
Dignity Health Past Accepting new patients
Last Frontier Healthcare District Past Accepting new patients

Locations

1100 Butte St
Redding, CA 96001
Phone (530) 227-6361

1950 Court St
Redding, CA 96001
Phone (530) 241-0778

2036 Railroad Ave
Redding, CA 96001
Phone (530) 225-8050

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518022698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2036 RAILROAD AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011801",
            "telephone_number": "530-255-1000",
            "fax_number": "530-247-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 RAILROAD AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011801",
            "telephone_number": "530-255-1000",
            "fax_number": "530-247-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENBERG",
        "first_name": "TIKOES",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G56842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ58543Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.