Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Jacob I. Blazzard , PA-C

Physician Assistant โ€ข Clarkston, WA

Active NPI 1326125485 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

1433 5th St
Clarkston, WA 994032714

Call 5097585141 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1433 5th St

Clarkston, WA 994032714

Telephone 5097585141
Fax 5097585299
Organization at the Same NPPES Address or Phone
Integrated Dermatology Of Clarkston Pllc Facility NPI 1609656222

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Integrated Dermatology Of Clarkston Pllc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2005

Medicare patients

1,262 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider, 2024.

Medicare-allowed amount

About $184,114 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Paid by Medicare

About $114,576 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

30-day fills

470 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$12,156 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers โ€“ by Provider and Drug, 2024.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $75.00 in 2025

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2025.

Guide: How to read an Open Payments record

Years since graduation

21 years (graduated 2005)

CMS Doctors and Clinicians data list 2005 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, โ€œDoes your provider accept Medicare as full payment?โ€

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Jacob Blazzard has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Jacob Blazzard as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Clarkston and Washington

Billing and prescribing volume is not a quality rating.

Medicare Part B services

More Medicare Part B services than 95% of clinicians listed under Physician Assistant in Washington (2024, 1,707 clinicians with data). Median for this group: 218. Middle half: 77 to 474.

Too few clinicians listed under Physician Assistant in Clarkston have Medicare Part B data for 2024 to compare.

Medicare-allowed amount

A higher Medicare-allowed amount than 95% of clinicians listed under Physician Assistant in Washington (2024, 1,707 clinicians with data). Median for this group: $16,952. Middle half: $6,879 to $34,613.

Too few clinicians listed under Physician Assistant in Clarkston have Medicare Part B data for 2024 to compare.

Paid by Medicare

A higher Medicare payment amount than 95% of clinicians listed under Physician Assistant in Washington (2024, 1,707 clinicians with data). Median for this group: $12,488. Middle half: $4,857 to $25,122.

Too few clinicians listed under Physician Assistant in Clarkston have Medicare Part B data for 2024 to compare.

Medicare Part D prescriptions

More Part D prescriptions than 60% of clinicians listed under Physician Assistant in Washington (2024, 2,001 clinicians with data). Median for this group: 244. Middle half: 75 to 797.

Too few clinicians listed under Physician Assistant in Clarkston have Medicare Part D data for 2024 to compare.

Part D drug cost

Close to the middle for clinicians listed under Physician Assistant in Washington (2024, 2,001 clinicians with data). Median for this group: $4,328. Middle half: $751 to $64,764.

Too few clinicians listed under Physician Assistant in Clarkston have Medicare Part D data for 2024 to compare.

4 active clinicians are listed under Physician Assistant with a practice address in Clarkston, WA (3,718 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments ยท Program Year 2025

Program year 2025 (payments made January 1 โ€“ December 31, 2025): fewer than 11 records totaling $75.00.

Manufacturer Payment Nature Product Type Amount ($)
Janssen Pharmaceuticals, Inc
Education
In-kind items and services
TREMFYA General $75.00

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B ยท Data Year 2024
Reporting Year:

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2018โ€“2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2019โ€“2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths
1,283 348 $15.00 $5.76
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
602 553 $107.33 $48.19
17000 Destruction of precancer skin growth, 1 growth
510 461 $127.48 $49.02
11102 Biopsy of related skin growth, first growth
376 358 $185.00 $85.61
99213 Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
353 321 $170.00 $77.01
99202 New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more
200 200 $135.00 $61.48
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
135 135 $206.96 $94.82
11103 Biopsy of related skin growth, each additional growth
70 56 $95.00 $42.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
48 44 $236.98 $107.43
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm
47 45 $558.30 $258.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
42 42 $311.43 $139.10
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm
36 33 $451.94 $105.06
69100 Biopsy of ear
24 23 $176.88 $69.99
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm
17 14 $328.24 $149.07
17281 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm
17 17 $332.06 $150.25
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm
13 12 $273.08 $123.22

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D ยท Data Year 2024
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Clobetasol Propionate Clobetasol Propionate 81 2,192 $3,479.43 55
Cephalexin Cephalexin 80 797 $462.18 77
Triamcinolone Acetonide Triamcinolone Acetonide 60 1,548 $658.57 51
Clindamycin Phosphate Clindamycin Phosphate 52 1,980 $1,813.25 33
Fluorouracil Fluorouracil 45 1,160 $3,298.75 45
Hydrocortisone Hydrocortisone 36 832 $147.75 28
Metronidazole Metronidazole 33 1,067 $1,653.40 19
Doxycycline Hyclate Doxycycline Hyclate 31 1,148 $590.33 19
Buspirone Hcl Buspirone Hcl 12 360 $51.93 โ€”

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-08-04
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES WA PA.PA.60099484

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.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

License # reported to NPPES WA PA60099484
Physician Assistant

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES ID PA-1221

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.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

License # reported to NPPES WY 361
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20100429000646

Enrollment State Jurisdiction

WA

PECOS Control ID

9335168392

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Integrated Dermatology Of Clarkston Pllc

1433 5th St, Clarkston, WA 994032714

Phone: 5097585141

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
NPI 1053313411

Doctor of Medicine (M.D.)

Jennifer Nicholas , FNP

Nurse Practitioner

NPI 1083978837

Family Nurse Practitioner

Carolyn Shoemaker , PA-C

Physician Assistant

NPI 1477856649

Physician Assistant (Certified)

NPI 1841269248

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

13 Historical Events
๐Ÿ“
Updated Business Mailing Address August 04, 2026

Registered at 4700 EXCHANGE CT STE 110, BOCA RATON, FL 334314450 (Tel: 5619480291)

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2026

Physician Assistant (license number reported to NPPES: WA PA60099484)

๐Ÿ“
Updated Practice Location August 24, 2022

Registered at 1433 5TH ST, CLARKSTON, WA 994032714 (Tel: 5097585141)

๐Ÿ“
Updated Business Mailing Address August 24, 2022

Registered at 901 RACHEL ST, TROY, ID 838716002 (Tel: 2083102777)

๐Ÿ“
Updated Practice Location February 20, 2019

Registered at 623 S MAIN ST STE 1, MOSCOW, ID 838432983 (Tel: 2088822011)

๐Ÿ“
Updated Business Mailing Address February 20, 2019

Registered at 700 S MAIN ST, MOSCOW, ID 838433046 (Tel: 2088824511)

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 20, 2019

Physician Assistant (license number reported to NPPES: ID PA-1221)

โœ…
NPI Profile Active December 31, 2014

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) December 31, 2014

Registered at 1205 SE PROFESSIONAL MALL BLVD, SUITE 104, PULLMAN, WA 991635423 (Tel: 5093322605)

๐Ÿ“
Business Mailing Address (Initial Record) December 31, 2014

Registered at 1205 SE PROFESSIONAL MALL BLVD, SUITE 104, PULLMAN, WA 991635423 (Tel: 5093322605)

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) December 31, 2014

Recorded as JACOB BLAZZARD, PA-C

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 31, 2014

Physician Assistant (license number reported to NPPES: WA PA60099484)

๐ŸŸข
Initial NPI Registration & Enumeration November 01, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1326125485
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 01, 2006
Last Update: August 04, 2026
Sole Proprietor: No

Other Physician Assistants in Clarkston

Mailing Address

4700 Exchange Ct Ste 110

Boca Raton, FL 334314450

Phone: 5619480291

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.