Mountain West Derm - Blackhart PLLC
NPI 1619517539 · Ambulatory Surgical Clinic/Center · Spokane Valley, WA
Enrolled with Medicare as Part B Supplier - Ambulatory Surgical Center · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mountain West Derm - Blackhart PLLC is a Ambulatory Surgical Clinic/Center organization in Spokane Valley, WA (NPI 1619517539).
Provider details
- NPI number
- 1619517539
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Bret Blackhart, Owner(775) 336-3624
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
6 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
646 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Full Thickness Skin Graft to Nose, Ears, Eyelids, Or Lips, 20.0 Sq Cm Or Less15260 | 192 | $938 |
| Repair of Wound of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Hands, Or Feet By Transferring Skin, 10.1-30.0 Sq Cm14041 | 111 | $933 |
| Repair of Wound of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.0 Sq Cm Or Less14060 | 84 | $915 |
| Repair of Wound of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Hands, Or Feet By Transferring Skin, 10.0 Sq Cm Or Less14040 | 63 | $902 |
| Repair of Wound By Transferring Skin, 30.1-60.0 Sq Cm14301 | 62 | $1,859 |
| Repair of Wound of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.1-30.0 Sq Cm14061 |
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Advanced Dermatology & Skin Surgery
Additional practice locations (1)
- 1700 W Riverstone DrCoeur D Alene, ID 83814-5683Phone: (208) 770-2822Fax: (208) 770-2911
Registry dates
- Enumerated
- 2020-01-08
- Last updated
- 2020-01-08
- Certified
- 2020-01-08
Frequently asked questions
- What is Mountain West Derm - Blackhart PLLC's NPI number?
- Mountain West Derm - Blackhart PLLC's National Provider Identifier (NPI) is 1619517539, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mountain West Derm - Blackhart PLLC?
- Mountain West Derm - Blackhart PLLC is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Mountain West Derm - Blackhart PLLC located?
- Mountain West Derm - Blackhart PLLC's practice location on file with NPPES is 1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444.
- What is Mountain West Derm - Blackhart PLLC's phone number?
- The practice phone number listed in the NPPES registry for Mountain West Derm - Blackhart PLLC is (509) 456-7414.
- Does Mountain West Derm - Blackhart PLLC accept Medicare?
- Mountain West Derm - Blackhart PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Mountain West Derm - Blackhart PLLC?
- The authorized official listed on Mountain West Derm - Blackhart PLLC's NPPES record is Bret Blackhart, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mountain West Derm - Blackhart PLLC's NPI active?
- Yes — Mountain West Derm - Blackhart PLLC's NPI (1619517539) is active in the NPPES registry as of the last update on 2020-01-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.