Blesilda A Mamerto, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00022291 Issued in WA

Practice address

800 West Maple Street
Medical Lake, WA 99022-0800

Phone

(509) 299-3121

Fax

(509) 299-7015

NPI assigned

Nov 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Department of Social Dept of SHS Div of Instns

  dba Eastern State Hospital

  • Psychiatric Hospital
  • Medical Lake, WA
  • NPI 1467440602
  Medicare reassignment NPD
• Department of Social

  dba Western State Hospital

  • Psychiatric Hospital
  • Tacoma, WA
  • NPI 1144295080
  NPD (past)
• Eastern State Hospital Pharmacy

  • Long Term Care Pharmacy
  • Medical Lake, WA
  • NPI 1679651970
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1801878756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800",
            "address_2": "800 WEST MAPLE STREET",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990220800",
            "telephone_number": "509-299-3121",
            "fax_number": "509-299-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEST MAPLE STREET",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990220800",
            "telephone_number": "509-299-3121",
            "fax_number": "509-299-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMERTO",
        "first_name": "BLESILDA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00022291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samaya Cassandra Lovegood, M.D.
• Alysha Lundberg
• Kevin Lee Lunsford, LMP
• Dyston R Madsen, DPT
• Muneeb Malik, M.D.
• Jennifer L Marshall, SLP
• Lawrence Moorer Martin, M.D.
• Lisa Mathews
• Rachelle McDonald, DDS
• Gretchen L. Meader, PHD

• Family Medicine Physician in Medical Lake, WA
• Providers in Medical Lake, 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 Jul 13, 2026; 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.