Organization Active NPI

Express Pediatrics

  • Pediatrics Physician
  • Pomona, NY
National Provider Identifier
1073227245
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
EXPRESS PEDIATRICS
Practice address
26 Firemens Memorial Dr Ste 120
Pomona, NY 10970-3576
Phone
(845) 712-6006
Fax
(845) 714-0994
NPI assigned
Jan 11, 2023
Organization subpart
Yes
Parent organization
EXPRESS PEDIATRICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Reuven Blobstein, MDNPI 1770014813
Title
MD/Owner
Phone
(845) 712-6006

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

26 Firemens Memorial Dr Ste 120
Pomona, NY 10970-3576

Mailing address

26 Firemens Memorial Dr Ste 120
Pomona, NY 10970-3576
Phone (845) 712-6006

Other names 1

  • Premier Pediatrics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260211004251 NY Part B Supplier - Clinic/Group Practice 7113406836 Receives reassigned benefits from 1 practitioner
Practice locations: Pomona, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2276504Express Pediatrics26 Firemens Memorial Dr, 1St Floor, Pomona, NY 10970Certificate of waiverFeb 8, 2027

National Provider Directory

National Provider Directory
Part of
Express Pediatrics

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1073227245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 FIREMENS MEMORIAL DR STE 120",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703576",
            "telephone_number": "845-712-6006",
            "fax_number": "845-714-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 FIREMENS MEMORIAL DR STE 120",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703576",
            "telephone_number": "845-712-6006",
            "fax_number": "845-714-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS PEDIATRICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXPRESS PEDIATRICS",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "BLOBSTEIN",
        "authorized_official_first_name": "REUVEN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "845-712-6006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pomona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.