Katherine RM Bloise, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD61223493 Issued in WA

Practice address

1400 Pottery Ave
Port Orchard, WA 98366-3711

Phone

(360) 895-5000

Fax

(360) 895-5034

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Katherine R McNally Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmcnally2270101@ghc.direct-ci.net

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1124264577

  Family Medicine

  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Richmond, CA
  • NPI 1235226531

  Family Medicine

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1699859660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 POTTERY AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663768",
            "telephone_number": "360-895-5000",
            "fax_number": "360-895-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 POTTERY AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663711",
            "telephone_number": "360-895-5000",
            "fax_number": "360-895-5034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Lakeville Hwy",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949545698",
            "country_code": "US",
            "telephone_number": "707-765-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOISE",
        "first_name": "KATHERINE",
        "middle_name": "RM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61223493",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G69357",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G693570",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1400 Pottery Ave",
            "city": "Port Orchard",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983663711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MCNALLY",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Lynn Bizak, DOULA
• Christie Marie Blaisdell, CBT
• Katherine Ann Blanchard, LMP
• Summerlee D Blankenship
• Trina Block, LMP
• Melany K Bloomquist, DDS
• Bock and Hutchinson, PLLC
• Jakob Chris Bock, DMD
• Bodiwerks 1, Inc
• Regina B Bonnevie-Rogers, MD

• Family Medicine Physician in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.