Karly Diana Blase, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

024029 Issued in NY

Practice address

47 New Scotland Ave
Albany, NY 12208-3412

Phone

(518) 262-3131

NPI assigned

Jul 26, 2019

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

Medicare fee-for-service enrollment

Enrolled in CA, NY2 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

Physician Assistant

Education

Albany Medical College of Union University, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Divinity Medical Services PLLC

  • Urgent Care Clinic/Center
  • Yorktown Heights, NY
  • NPI 1497159560
  Medicare reassignment Care Compare group
• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688
  Medicare reassignment
• Physicians Medical Associates New York PC

  • Emergency Medicine Physician
  • Syracuse, NY
  • NPI 1073386421
  Medicare reassignment
• Sierra Emergency Medical Group Inc.

  • Emergency Medicine Physician
  • Sonora, CA
  • NPI 1871732933
  Medicare reassignment
• Albany Medical College

  • Emergency Medicine Physician
  • Albany, NY
  • NPI 1174553093

  Physician Assistant

  NPD
• Albany Medical College

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD
• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1386689248

  Physician Assistant

  NPD

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1891349098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TRUAX LN",
            "city": "GUILDERLAND",
            "state": "NY",
            "postal_code": "120843502",
            "telephone_number": "347-397-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-3131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Greenley Rd",
            "address_purpose": "LOCATION",
            "city": "Sonora",
            "state": "CA",
            "postal_code": "953705200",
            "country_code": "US",
            "telephone_number": "209-536-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLASE",
        "first_name": "KARLY",
        "middle_name": "DIANA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA57042",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyse Sherwin Blanchette, M.D.
• Catherine Rose Blanchfield, DPT
• Caitlyn Jenna Bland
• Chelsea E Blaney, PA
• Penelope M Blasch, PT
• Jacqueline Blass, PSYD
• Sarah J Blatz, RPA-C
• Mary Beth Blaustein
• Abigail Louise Bleier, PHARMD
• David Blemings, FNP

• Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.