Individual provider Active NPI

Sinclair Everade Blake Jr., PA-C

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1972688703
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003885 Issued in WA
Practice address
2221 Stockton Blvd
Sacramento, CA 95817-1418
Phone
(916) 734-7622
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60143 CA
Physician Assistant 363A00000X PA10003885 WA Primary

Addresses

Primary practice location

2221 Stockton Blvd
Sacramento, CA 95817-1418

Mailing address

2221 Stockton Blvd
Sacramento, CA 95817-1418

Other practice location 1

University Of Washington Medical Ctr
1959 NE Pacific St
Seattle, WA 98195-6165
Phone (206) 598-4477

Other practice location 2

1100 Goethals Dr Ste E
Richland, WA 99352-3301
Phone (509) 942-3095

Other identifiers 2

IdentifierTypeStateIssuer
8411316MedicaidWA
327250OtherINTERNAL ID-MOTOR VEHICLE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA, AZ3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20041019000490 WA Practitioner - Physician Assistant 9133017858 Reassigns benefits to 1 organization
I20230509002893 CA Practitioner - Physician Assistant 9133017858 Reassigns benefits to 1 organization
I20230531002619 AZ Practitioner - Physician Assistant 9133017858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8749AZMDChiropractor
PA60143CAMDPhysician Assistant
PA10003885WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 5, 2022 Accepting new patients
Multicare Health System CurrentSince Oct 5, 2022 Accepting new patients
Yuma Regional Medical Center CurrentSince May 15, 2023 Accepting new patients
Regents of the Univ of Ca CurrentSince Jan 14, 2023 Accepting new patients
Pocatello Hospital LLC Current Accepting new patients
Regents of the Univ of Ca CurrentSince Jan 14, 2023 Accepting new patients
Regents of the Univ of Ca CurrentSince Jan 14, 2023 Accepting new patients
Cardiovascular Surgery Associates PastSince Oct 1, 2010 Accepting new patients

Locations

2460 S Parkview Loop
Ste 203
Yuma, AZ 85364
Phone (928) 336-2619

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

777 Hospital Way
Ste G11
Pocatello, ID 83201
Phone (208) 239-1710

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Interoperability endpoints

  • Direct secure messaging: sblake2285655@wm.providencedirect.org
  • Direct secure messaging: sblake89279@direct.ehre.uwmedicine.org
  • Direct secure messaging: awilliams916349@ahs.direct-ci.com

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1972688703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171418",
            "telephone_number": "916-734-7622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University Of Washington Medical Ctr",
            "address_2": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981956165",
            "country_code": "US",
            "telephone_number": "206-598-4477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Goethals Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523301",
            "country_code": "US",
            "telephone_number": "509-942-3095",
            "fax_number": "509-942-3097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "SINCLAIR",
        "middle_name": "EVERADE",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60143",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8411316",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "327250",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.