Individual provider Active NPI

Julia Blank, MD

  • Family Medicine Physician
  • Pacific Palisades, CA
National Provider Identifier
1891736757
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A83790 Issued in CA
Practice address
881 Alma Real Dr Ste 101
Pacific Palisades, CA 90272-3792
Phone
(310) 829-8923
Fax
(424) 212-5936
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A83790 CA Primary

Addresses

Primary practice location

881 Alma Real Dr Ste 101
Pacific Palisades, CA 90272-3792

Mailing address

881 Alma Real Dr
316
Pacific Palisades, CA 90272
Phone (310) 829-8923

Other practice location 1

881 Alma Real Dr
214
Pacific Palisades, CA 90272-3731
Phone (310) 459-2363

Other identifiers 1

IdentifierTypeStateIssuer
W14560DOtherCAMEDICARE PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jblank472968@oc.providencedirect.org
Direct Messaging Address jblank472968@oc.providencedirect.org

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040519000572 CA Practitioner - Family Practice 2062403132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A83790CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Santa Monica Bay Area Physicians Family Medicine Past Accepting new patients

Locations

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

881 Alma Real Dr
Ste 101
Pacific Palisades, CA 90272
Phone (310) 454-2296

881 Alma Real Dr
Ste 316
Pacific Plsds, CA 90272
Phone (310) 454-1317

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

1831 Wilshire Blvd
Ste B
Santa Monica, CA 90403
Phone (310) 400-5565

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1891736757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 ALMA REAL DR",
            "address_2": "316",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "90272",
            "telephone_number": "310-829-8923",
            "fax_number": "424-212-5936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 ALMA REAL DR STE 101",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723792",
            "telephone_number": "310-829-8923",
            "fax_number": "424-212-5936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "881 Alma Real Dr",
            "address_2": "214",
            "address_purpose": "LOCATION",
            "city": "Pacific Palisades",
            "state": "CA",
            "postal_code": "902723731",
            "country_code": "US",
            "telephone_number": "310-459-2363",
            "fax_number": "310-459-1517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANK",
        "first_name": "JULIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A83790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "W14560D",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jblank472968@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "881 Alma Real Dr Ste 101",
            "city": "Pacific Palisades",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902723792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jblank472968@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1831 Wilshire Blvd Ste B",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904035778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pacific Palisades, CA

Sources for this page

Verify at the official NPI Registry.