NPIMap

Individual provider Active NPI

William Raymond Blazey, D.O.

  • Family Medicine Physician
  • Old Westbury, NY
National Provider Identifier
1053405498
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
242013 Issued in NY
Practice address
Northern Blvd
Academic Health Care Center
Old Westbury, NY 11568-8000
Phone
(516) 686-1300
Fax
(516) 686-7890
NPI assigned
Oct 2, 2006
Last updated
Sep 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 242013 NY Primary

Addresses

Primary practice location

Northern Blvd
Academic Health Care Center
Old Westbury, NY 11568-8000

Mailing address

Northern Blvd
Academic Health Care Center
Old Westbury, NY 11568-8000
Phone (516) 686-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080920000046 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 5193892909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

415 E Main St
Endicott, NY 13760-4925
Phone (607) 785-2460

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242013NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. Family Medicine Current Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Jan 20, 2025 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Jan 20, 2025 Accepting new patients
New York Institute of Technology Family Medicine CurrentSince Aug 15, 2008 Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients
New York Institute of Technology Family Medicine Current Accepting new patients
New York Institute of Technology Family Medicine CurrentSince Aug 15, 2008 Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

267 Carleton Ave
Central Islip, NY 11722
Phone (631) 348-3254

415 E Main St
Endicott, NY 13760
Phone (607) 785-2460

600 Northern Blvd
Greenvale, NY 11548
Phone (516) 686-3849

500 5th Ave
Owego, NY 13827
Phone (607) 687-1122

Interoperability endpoints

  • Direct secure messaging: wblazey219873@direct-guthrie.org

Organizations & group practices 7

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 3

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1053405498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTHERN BLVD",
            "address_2": "ACADEMIC HEALTH CARE CENTER",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115688000",
            "telephone_number": "516-686-1300",
            "fax_number": "516-686-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTHERN BLVD",
            "address_2": "ACADEMIC HEALTH CARE CENTER",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115688000",
            "telephone_number": "516-686-1300",
            "fax_number": "516-686-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZEY",
        "first_name": "WILLIAM",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "242013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Westbury, NY

Sources for this page

Verify at the official NPI Registry.