Individual provider Active NPI

Julie Blanchard

  • Physician Assistant
  • San Rafael, CA
National Provider Identifier
1659833291
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57360 Issued in CA
Practice address
50 Acacia Ave
San Rafael, CA 94901-2230
Phone
(617) 877-3508
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57360 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

50 Acacia Ave
San Rafael, CA 94901-2230

Mailing address

250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone (617) 877-3508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200408002778 CA Practitioner - Physician Assistant 4789013095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians

Practice addresses (Care Compare)

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Hospital & facility affiliations

  • Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57360CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jblanchard79536@direct-ucsfmedicalcenter.org

Organizations & group practices 2

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1659833291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BON AIR RD",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041702",
            "telephone_number": "617-877-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ACACIA AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012230",
            "telephone_number": "617-877-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "JULIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57360",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.