NPI age
8 years
Enumerated 2018-04-04
● Active
Type 1 · Individual
Justin Blaty, MD
Blaty is 1 of 1 pediatrics providers in Boise and 1 of 1 in Idaho.
Primary specialty
Pediatrics
Plus 3 subspecialties
Licensed in
ID, WI, WA
3 states
Status
Active
No deactivations on record
Last NPPES update
2024-05-19
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1 active pediatrics providers in Idaho.
NPI age
8 years
≈ at median (8 yr)
State licenses
3 states
Top 0% — 100% of peers are multi-state
Subspecialties
1
In the 100% of peers with subspecialties
NPI lifetime · 2018 → 2026
2018-04Enumerated in NPPES
2018
2026
Where they practice
Practice location
1075 N Curtis Rd Ste 201
Boise, ID 837061350
Mailing address
Po Box 190930
Boise, ID 837190930
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
1959 Ne Pacific St
Seattle, WA 981951009
Location 3
1626 Tuttle St
Baraboo, WI 539131501
Specialties
-
Pediatrics PrimaryA Pediatrician who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm...
-
Student in an Organized Health Care Education/Training ProgramAn individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (WI) | 1548766835 |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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