NPIMap

Individual provider Active NPI

Rachelle Ann Blanc, DO

  • Family Medicine Physician
  • Kenai, AK
National Provider Identifier
1972064145
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
189243 Issued in AK
Practice address
506 Lake St
Kenai, AK 99611-6937
Phone
(907) 714-4025
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 189243 AK Primary

Addresses

Primary practice location

506 Lake St
Kenai, AK 99611-6937

Mailing address

250 Hospital PL
Soldotna, AK 99669-7559

Other practice location 1

7060 Clairemont Mesa Blvd
San Diego, CA 92111-1003
Phone (858) 573-6409

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rblanc2595111@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221217000198 AK Practitioner - Family Practice 0840684247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, New York, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Peninsula General Hospital IncGroup PAC ID 4587552575, 119 clinicians

Practice addresses (Care Compare)

506 Lake St
Kenai, AK 99611-6937
Phone (907) 714-4025

Hospital & facility affiliations

  • Kenai Peninsula Home Health, LLC Home health agency, Soldotna, AK, CCN 027038
  • Central Peninsula General Hospital Hospital, Soldotna, AK, CCN 020024

Merit-based Incentive Payment System (MIPS)

Final score
75.44 of 100Reported as group
Quality
62.56
Promoting interoperability
81
Improvement activities
40
Cost
67.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1074CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Peninsula General Hospital Inc. Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince Sep 9, 2022 Accepting new patients
Medical Network of Alaska, LLC CurrentSince Sep 9, 2022 Accepting new patients
North Star Medical Imaging PLLC Current Accepting new patients
Central Peninsula General Hospital, Inc CurrentSince May 29, 2024 Accepting new patients
Central Peninsula General Hospital Inc CurrentSince May 29, 2024 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Central Peninsula General Hospital Inc Past Accepting new patients
Central Peninsula General Hospital Inc Past Accepting new patients

Locations

10543 Kenai Spur Hwy
Kenai, AK 99611
Phone (907) 283-9118

506 Lake St
Kenai, AK 99611
Phone (907) 714-4025

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

Interoperability endpoints

  • Direct secure messaging: rblanc2595111@ak.providencedirect.org

Organizations & group practices 9

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1972064145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 LAKE ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996116937",
            "telephone_number": "907-714-4025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7060 Clairemont Mesa Blvd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921111003",
            "country_code": "US",
            "telephone_number": "858-573-6409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANC",
        "first_name": "RACHELLE",
        "middle_name": "ANN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "189243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rblanc2595111@ak.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "Provider direct messaging address",
            "address_1": "506 Lake St",
            "city": "Kenai",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996116937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

Verify at the official NPI Registry.