Active NPI
Jill June Blacharsh, MD
- Psychiatry Physician
- Albuquerque, NM
National Provider Identifier
1972574416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 86-175
- Practice address
- 224 Montclaire Dr NE
Albuquerque, NM 87108-1124 - Phone
- (505) 264-5770
- NPI assigned
- Feb 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 86-175 | NM | Primary |
Addresses
Primary practice location
224 Montclaire Dr NE
Albuquerque, NM 87108-1124
Mailing address
224 Montclaire Dr NE
Albuquerque, NM 87108-1124
Phone (505) 264-5770
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85031326887301A154 | Other | NM | CHAMPUS |
| 201000856 | Other | NM | PRESBYTERIAN HEALTH/SALUD |
| 9605 | Medicaid | NM | |
| NM0023965 | Other | NM | BCBS |
| 826589 | Medicaid | AZ | |
| 10009939 | Other | NM | LOVELACE HEALTH/SALUD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86-175 | NM | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682899200000",
"number": "1972574416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 MONTCLAIRE DR NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871081124",
"telephone_number": "505-264-5770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 MONTCLAIRE DR NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871081124",
"telephone_number": "505-264-5770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACHARSH",
"first_name": "JILL",
"middle_name": "JUNE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-01",
"last_updated": "2023-05-01",
"certification_date": "2023-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NM",
"license": "86-175",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "85031326887301A154",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN HEALTH/SALUD",
"identifier": "201000856",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9605",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "NM0023965",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "826589",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOVELACE HEALTH/SALUD",
"identifier": "10009939",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.