Jennifer Blitz, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

013716 Issued in NY

Practice address

111 Smithtown Byp
Suite 121
Hauppauge, NY 11788-2524

Phone

(631) 742-8523

Fax

(631) 979-0438

NPI assigned

Mar 19, 2007

Last updated

Jan 25, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dawn Friedland-Perez LCSW,PCGroup PAC ID 2365494861, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dawn Friedland-Perez, LCSW, P.C.

  • Clinical Social Worker
  • Port Jefferson Station, NY
  • NPI 1790711224
  Medicare reassignment Care Compare group NPD
• Campbell and Santoro Psychologists, PC

  • Psychologist
  • Hollis, NY
  • NPI 1124072210
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1013031483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NORMA LN",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117544520",
            "telephone_number": "631-742-8523",
            "fax_number": "631-979-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SMITHTOWN BYP",
            "address_2": "SUITE 121",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882524",
            "telephone_number": "631-742-8523",
            "fax_number": "631-979-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLITZ",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P3479888",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS",
            "identifier": "041691",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marlies Bisso
• Tanjalyn Black
• Frandia Blaise
• Lauren Blanco
• Robin L Bliss, MD
• Leah Block
• Steven David Blonder, DDS
• Natalie Mursteine Bodden, NP
• Body in Balance Physical Therapy
• Body in Balance Physical Therapy

• Clinical Psychologist in Hauppauge, NY
• Providers in Hauppauge, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.