Jacob I Blazzard, PA-C - Medicare Physician Assistant in Clarkston, WA

  1. Home
  2. Physician Assistant
  3. WA
  4. Clarkston
Jacob I Blazzard, PA-C is a medicare enrolled "Physician Assistant" in Clarkston, Washington. He graduated from nursing school in 2005 and has 21 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Integrated Dermatology Of Clarkston Pllc and his current practice location is 1433 5th St, Clarkston, Washington. You can reach out to his office (for appointments etc.) via phone at (509) 758-5141.

Jacob I Blazzard is licensed to practice in Washington (license number PA.PA.60099484) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1326125485.

Contact Information

Jacob I Blazzard, PA-C
1433 5th St,
Clarkston, WA 99403-2714
(509) 758-5141
(509) 758-5299

Map and Direction




Provider's Profile

Full NameJacob I Blazzard
GenderMale
SpecialityPhysician Assistant
Experience21 Years
Location1433 5th St, Clarkston, Washington
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jacob I Blazzard graduated from nursing school in 2005
  NPI Data:
  • NPI Number: 1326125485
  • Provider Enumeration Date: 11/01/2006
  • Last Update Date: 08/04/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 9335168392
  • Enrollment ID: I20100429000646

Medical Identifiers

Medical identifiers for Jacob I Blazzard such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1326125485NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical PA60099484 (Washington)Secondary
363A00000XPhysician Assistant PA-1221 (Idaho)Secondary
363A00000XPhysician Assistant PA.PA.60099484 (Washington)Primary
363AM0700XPhysician Assistant - Medical 361 (Wyoming)Secondary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Integrated Dermatology Of Clarkston Pllc55971023356

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jacob I Blazzard allows following entities to bill medicare on his behalf.
Entity NameWalter L Williams
Entity TypePractitioner - Dermatology
Entity IdentifiersNPI Number: 1841269248
PECOS PAC ID: 4385610757
Enrollment ID: I20040908000156
Entity NameIntegrated Dermatology of Clarkston PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609656222
PECOS PAC ID: 5597102335
Enrollment ID: O20240328001331

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacob I Blazzard is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jacob I Blazzard, PA-C
4700 Exchange Ct Ste 110,
Boca Raton, FL 33431-4450

Ph: (561) 948-0291		Jacob I Blazzard, PA-C
1433 5th St,
Clarkston, WA 99403-2714

Ph: (509) 758-5141

Reviews and Comments


Physician Assistant Nurses in Clarkston, WA

Mr. Gregory Robert Obray, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1207 Evergreen Ct, Clarkston, WA 99403
Phone: 509-769-2254    Fax: 509-769-2255
Mr. Tyler Lee Anderson, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 1119 Highland Ave Ste 4, Clarkston, WA 99403
Phone: 509-254-0080    Fax: 509-254-0079
Carolyn Jean Shoemaker, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1433 5th St, Clarkston, WA 99403
Phone: 509-758-5141    Fax: 509-758-5299
Victoria Ozeran, PA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 1119 Highland Ave Ste 11, Clarkston, WA 99403
Phone: 509-758-4450    
Mr. Kyle Marlin Hoffmann, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1221 Highland Ave, Clarkston, WA 99403
Phone: 509-758-5511    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.