Individual provider Active NPI

James J. Blatzer, P.A.-C.

  • Physician Assistant
  • Danville, IL
National Provider Identifier
1922015130
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085000740 Issued in IL
Practice address
1900 E Main St
Danville, IL 61832
Phone
(217) 554-3000
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085000740 IL Primary

Addresses

Primary practice location

1900 E Main St
Danville, IL 61832

Mailing address

1900 E Main St
Danville, IL 61832-5100
Phone (217) 554-3000

Other practice location 1

1801 Windsor Rd
Champaign, IL 61822-6217
Phone (217) 366-8105

Other practice location 2

1801 Windsor Rd
Champaign, IL 61822-6217
Phone (217) 366-8105

Other identifiers 2

IdentifierTypeStateIssuer
970010117OtherILRAILROAD MEDICARE
434110OtherILMEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20200422000574 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6103816509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085000740ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christie Clinic, PLLC PastSince Apr 1, 2006 Accepting new patients
Illiana Emergency Physicians LLP Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Organizations & group practices 3

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1922015130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E MAIN ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325100",
            "telephone_number": "217-554-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E MAIN ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "61832",
            "telephone_number": "217-554-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Windsor Rd",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618226217",
            "country_code": "US",
            "telephone_number": "217-366-8105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 Windsor Rd",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618226217",
            "country_code": "US",
            "telephone_number": "217-366-8105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLATZER",
        "first_name": "JAMES",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085000740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970010117",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "434110",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

Verify at the official NPI Registry.