Desirae Bloomquist, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

202108299NP-PP Issued in OR

Practice address

3377 Riverbend Dr
Springfield, OR 97477-8803

Phone

(541) 222-6565

Fax

(541) 222-6567

NPI assigned

Jun 3, 2018

Last updated

Apr 5, 2022By the provider in NPPES

Sex

Female

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 WA, OR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Medical GroupGroup PAC ID 9032023270, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dbloomquist536230@direct.peacehealth.org

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.

• Peacehealth Medical Group

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1447207287
  Medicare reassignment Care Compare group NPD
• Kittitas County Public Hospital Dist 1

  dba Kittitas Valley Community Hospital

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307
  Medicare reassignment NPD
• Peacehealth Medical Group

  dba Nurse Midwifery Birth Center

  • Birthing Clinic/Center
  • Springfield, OR
  • NPI 1881860856
  NPD
• Kittitas County Public Hosp Dist 1

  dba KVH Urology

  • Urology Physician
  • Ellensburg, WA
  • NPI 1437029832
  NPD
• Kittitas County Public Hospital Dist 1

  dba KVH Family Medicine - Cle Elum

  • Rural Health Clinic/Center
  • Cle Elum, WA
  • NPI 1194747774
  NPD

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

• Peacehealth

  dba Sacred Heart-RiverBend

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1083888515
  Care Compare affiliation
• Peacehealth

  • Psychiatric Hospital Unit
  • Eugene, OR
  • NPI 1568236974
  Care Compare affiliation

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

{
    "created_epoch": "1527984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1699267963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 S BLAKELEY ST",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982722207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3377 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "541-222-6565",
            "fax_number": "541-222-6567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "716 E Manitoba Ave",
            "address_purpose": "LOCATION",
            "city": "Ellensburg",
            "state": "WA",
            "postal_code": "989263842",
            "country_code": "US",
            "telephone_number": "509-933-8777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2484 River Rd",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974042042",
            "country_code": "US",
            "telephone_number": "541-222-7650",
            "fax_number": "541-222-7630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4010 Aerial Way",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974029757",
            "country_code": "US",
            "telephone_number": "541-687-6353",
            "fax_number": "541-242-8413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOMQUIST",
        "first_name": "DESIRAE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-03",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202108299NP-PP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60909323",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60766318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Blake
• Jane Bland
• Andrea Blattler, FNP
• Cindy Bloom, LMT
• Charles Michael Bloom, Jr., QMHP
• Karen Anne Blundon, PA-C
• Barry Blyton, M.D.
• Benjamin R Bock, PHD
• Gustav Aiden Bock
• Kimberly A Bock, M.D.

• Nurse Practitioner in Springfield, OR
• Providers in Springfield, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.