Johan Blickman, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

44956 Issued in MA

Practice address

601 Elmwood Ave
Rochester, NY 14642-8648

Phone

(585) 275-2734

Fax

(585) 273-1033

NPI assigned

Jul 1, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Boston University Medical Center Radiologists, Inc.

  • Diagnostic Radiology Physician
  • Boston, MA
  • NPI 1134166945

  Pediatric Radiology

  NPD (past)

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1013145838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428648",
            "telephone_number": "585-275-2734",
            "fax_number": "585-273-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428648",
            "telephone_number": "585-275-2734",
            "fax_number": "585-273-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLICKMAN",
        "first_name": "JOHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "MA",
            "license": "44956",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "44956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marley Blattner
• Mark Blazey, MS, CRNA
• Marjorie T Bleeg, LCSW-R
• Stefanie Marija Blejec
• Jennifer Blender, PHD
• Timothy M. Blieden, DDS
• Kimberlee Ann Bliek, RN
• Leah A Bliek, CRNA
• Aidan Matthew Bligh
• Rebecca Michele Bliss-Gordner, MS OTR/L

• Diagnostic Radiology Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.