MICHAEL P BLASKO (PA) – Physician Assistant, NPI 1124100300

MICHAEL P BLASKO (PA) is a healthcare provider. based in Newport beach, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 00000PA17281 (CA). The NPI Number for MICHAEL P BLASKO (PA) is 1124100300

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL P BLASKO (PA)
NPI
1124100300
Phone
(949) 335-7500
Address
4631 TELLER AVE STE 100
Enumeration Date
19 October 2006
Last Update Date
1 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7144567004
Graduation Year
2003 (23 years ago)
PAC ID
9931151362
Group Practice PAC ID
4082510250
Professional Enrollment ID
I20050214001019
Address ID
CA928683201OR101XXSXXX500

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

10,564 PHYSICIAN ASSISTANT in CA

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Provider Addresses for MICHAEL P BLASKO (PA)

  • Teller Avenue, Newport Beach, Orange County, California, 92660, United States

    NEWPORT BEACH, CA 926608105

    Phone: (949) 335-7500

    Fax: (949) 387-1206

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-02-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050214001019IPhysician AssistantCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92660)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082510250View full group profile
NameSpecialtyState
N E U R O S U R G E R YCA
Physician AssistantCA
Physician AssistantCA
N E U R O S U R G E R YCA
N E U R O S U R G E R YCA
N E U R O S U R G E R YCA
N E U R O L O G YCA
N E U R O S U R G E R YCA
Physician AssistantCA
N E U R O S U R G E R YCA

Reviews

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Frequently asked questions

What unique ID ties claims to MICHAEL P BLASKO (PA)?
NPI 1124100300 is assigned to MICHAEL P BLASKO (PA) under the national enumeration system.
Is MICHAEL P BLASKO (PA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does MICHAEL P BLASKO (PA) treat or focus on?
Patients typically see MICHAEL P BLASKO (PA) under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for MICHAEL P BLASKO (PA)?
The page summarizes Newport Beach, California for MICHAEL P BLASKO (PA); expand the address list for detail.
How can I contact MICHAEL P BLASKO (PA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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