Individual provider Active NPI

Janet Blasko, D.O.

  • Internal Medicine Physician
  • Puyallup, WA
National Provider Identifier
1932415692
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OP60943803 Issued in WA
Practice address
401 15TH Ave SE
Puyallup, WA 98372
Phone
(253) 697-4000
NPI assigned
Aug 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60167254 WA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X OP60943803 WA Primary

Addresses

Primary practice location

401 15TH Ave SE
Puyallup, WA 98372

Mailing address

5514 160TH Ave NE
Redmond, WA 98052-5223
Phone (614) 560-9305

Other practice location 1

401 15th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Other identifiers 1

IdentifierTypeStateIssuer
PG178225OtherORMEDICAL LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20190912001760 WA Practitioner - Internal Medicine 4486947462 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PH60167254WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients

Locations

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

401 15th Ave SE
Puyallup, WA 98372
Phone (253) 697-1848

Interoperability endpoints

  • Direct secure messaging: jblasko195960@direct.multicare.org

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": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1932415692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5514 160TH AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525223",
            "telephone_number": "614-560-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 15TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98372",
            "telephone_number": "253-697-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 15th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "98372",
            "country_code": "US",
            "telephone_number": "253-697-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLASKO",
        "first_name": "JANET",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60167254",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP60943803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE #",
            "identifier": "PG178225",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.