Justin Blackmon

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

53958 Issued in CA

Practice address

9888 Genesee Ave
La Jolla, CA 92037-1205

Phone

(858) 626-4123

NPI assigned

Jul 21, 2014

Last updated

Oct 31, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Jolla Observation MedicineGroup PAC ID 2365727492, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324

Merit-based Incentive Payment System (MIPS)

Final score

91.15 of 100Reported as group

Quality

86.59

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jblackmon33292@scrippshlth.medalliesdirect.net

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.

• La Jolla Observation Medicine

  • Emergency Medicine Physician
  • La Jolla, CA
  • NPI 1780122986
  Medicare reassignment Care Compare group
• La Jolla Emergency Specialists

  • Emergency Medicine Physician
  • La Jolla, CA
  • NPI 1710315353
  Medicare reassignment
• Scripps Health

  dba Scripps Hospital Medical Services

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD

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

• Scripps Health

  dba Scripps Memorial Hospital La Jolla

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  Care Compare affiliation

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1699182832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4818 GLENDARION DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9888 GENESEE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371205",
            "telephone_number": "858-626-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA031058",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53958",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.005596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Jeanne Binkin
• Lisa Bird-Hollander, P.T.
• Margaret Natalie-Haslett Bischer, A-GNP-C
• Joseph Steven Bitterman, RPH
• Laura Marie Biver, MD
• Gerard Francis Blake, MD
• Jade Blanchard
• Joseph A Blatt, MD
• Kathleen M Blechertas, DPT, WCC, FACHE
• Rebecca Blenz, LMFT

• Physician Assistant in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.