Active NPI
Mirjana Blokar, M.D.
- Psychiatry Physician
- New York, NY
National Provider Identifier
1003017443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 137190
- Practice address
- 65 Bleecker St
12TH Floor
New York, NY 10012-2420 - Phone
- (212) 505-2652
- NPI assigned
- May 31, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalyst | 102L00000X | 137190 | NY | |
| Psychiatry Physician | 2084P0800X | 137190 | NY | Primary |
Addresses
Primary practice location
65 Bleecker St
12TH Floor
New York, NY 10012-2420
Mailing address
65 Bleecker St
12TH Floor
New York, NY 10012-2420
Phone (212) 505-2652
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00367946 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1003017443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 BLEECKER ST",
"address_2": "12TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100122420",
"telephone_number": "212-505-2652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 BLEECKER ST",
"address_2": "12TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100122420",
"telephone_number": "212-505-2652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOKAR",
"first_name": "MIRJANA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-31",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "NY",
"license": "137190",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "137190",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00367946",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.