JARED BLACKMORE PA-C NPI 1649559014

NPI Information

  • NPI: 1649559014
  • Provider Name: JARED BLACKMORE, PA-C
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10506A MONTGOMERY RD
    MONTGOMERY, OH
    ZIP 45242
  • Phone: (513) 865-5120

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NPI Details

Jared Blackmore, PA-C is a physician assistant in Montgomery, OH with 15 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Jared Blackmore, PA-C NPI is 1649559014. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10506A MONTGOMERY RD
MONTGOMERY, OH
ZIP 45242-402
Phone: (513) 865-5120
Fax: (513) 865-9875

The NPI 1649559014 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Coronary artery bypass using artery graft, 1 graft (HCPCS:33533)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)
  • Replacement of aortic valve on heart-lung machine (HCPCS:33405)
  • Coronary artery bypass using vein or artery graft, 2 grafts (HCPCS:33518)
  • Coronary artery bypass using vein or artery graft, 1 graft (HCPCS:33517)

The enumeration date for this NPI number is 8/16/2011 and was last updated on 5/31/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant50.003392OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10067767MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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