Individual provider Active NPI

Adam Blaisdell

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1013448471
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
564 1St Ave
Apt 17K
New York, NY 10016-6482
Phone
(651) 271-1496
NPI assigned
Mar 27, 2017
Last updated
Mar 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

564 1St Ave
Apt 17K
New York, NY 10016-6482

Mailing address

564 1St Ave
Apt 17K
New York, NY 10016-6482
Phone (651) 271-1496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230728000791 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 1658783881 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
New York University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

Practice addresses (Care Compare)

1701 Divisadero St
San Francisco, CA 94115-3011
Phone (415) 476-4029

225 California Dr
Burlingame, CA 94010-4145
Phone (650) 341-9131

400 Parnassus Ave
San Francisco, CA 94143-2202

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-4029

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy45
Upper gastrointestinal (GI) endoscopy for acid reflux45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Jun 30, 2023 Accepting new patients
University of California San Francisco CurrentSince Jun 30, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 30, 2023 Accepting new patients
University of California San Francisco CurrentSince Jun 30, 2023 Accepting new patients
Regents of the University of California CurrentSince Jun 30, 2023 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
Regents of the University of California Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

1600 Divisadero St
San Francisco, CA 94143
Phone (415) 353-7175

1701 Divisadero St
San Francisco, CA 94115
Phone (415) 353-7300

2001 The Embarcadero
Ofc Of
San Francisco, CA 94143
Phone (628) 224-5503

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

513 Parnassus Ave
#S357
San Francisco, CA 94143
Phone (415) 353-2318

513 Parnassus Ave
Ste S357
San Francisco, CA 94143

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1013448471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 1ST AVE",
            "address_2": "APT 17K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166482",
            "telephone_number": "651-271-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 1ST AVE",
            "address_2": "APT 17K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166482",
            "telephone_number": "651-271-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.