BRYAN BLYTHE – Medical Physician Assistant, NPI 1366422602

BRYAN BLYTHE is a healthcare provider. based in Bremerton, Washington. specializing in PHYSICIAN ASSISTANT. They hold a License No. PA10003484 (WA). The NPI Number for BRYAN BLYTHE is 1366422602

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
BRYAN BLYTHE
NPI
1366422602
Phone
(360) 475-4426
Address
1 BOONE RD
Enumeration Date
20 January 2006
Last Update Date
3 March 2025

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
5092221275
Graduation Year
1998 (28 years ago)
PAC ID
2860676525
Group Practice PAC ID
6709013105
Professional Enrollment ID
I20130325000539
Address ID
WA993368106KE8508XBLVD402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,282 PHYSICIAN ASSISTANT in WA

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Provider Addresses for BRYAN BLYTHE

  • Boone Road, Jackson Park, Jackson Park Support Area, Kitsap County, Washington, 98312, United States

    BREMERTON, WA 983121894

    Phone: (360) 475-4426

    Fax: (360) 475-4344

    Type: Location

  • 500 SW 7th St Ste A205

    Renton, WA 980572983

    Phone: (877) 522-1275

    Fax: (833) 888-7145

    Type: Location

  • 16410 SMOKEY POINT BLVD STE 101

    ARLINGTON, WA 982238415

    Phone: (877) 522-1275

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $26.

Total Amount is formed as General ($26) + Research ($0) + Ownership ($0) = $26.

Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Braeburn Inc. ($26).

Total Amount

$26

General + Research + Ownership

Payments

1

Total payment records

General Amount

$26

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-19

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Braeburn Inc.$26
View all Open Payments →|Open Payments Risk Radar →

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: 2024-01-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 4 Medicare enrollment records; no due dates published yet.

Enrollment records

4

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
I20130325000539IPhysician AssistantWATBD
I20210322002168IPhysician AssistantMTTBD
I20220131001016IPhysician AssistantNMTBD
I20240130003284IPhysician AssistantIDTBD

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 98312)

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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: 6709013105View full group profile
NameSpecialtyState
Hospitalist, Internal MedicineWA
Physician AssistantTX
-MD
-CA
-WA
Physician AssistantWA
-MN
Nurse PractitionerWA
Physician AssistantFL

Reviews

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Frequently asked questions

Can I cross-check BRYAN BLYTHE using NPI 1366422602?
NPI 1366422602 belongs to BRYAN BLYTHE; compare other details if you need extra assurance.
Active or inactive — what applies to BRYAN BLYTHE?
You should see BRYAN BLYTHE as active in CMS-hosted NPPES data.
What expertise is attributed to BRYAN BLYTHE?
BRYAN BLYTHE's specialty line reads Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for BRYAN BLYTHE?
Travel planning: use Bremerton, Washington as the reference point for BRYAN BLYTHE, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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