David Marc Blaustein, MD

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

78218 Issued in MA

Practice address

1400 VFW Parkway
VA Boston Healthcare System
West Roxbury, MA 02132

Phone

(857) 203-6931

Fax

(857) 203-5680

NPI assigned

Sep 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• South Shore Physiatry and Spasticity Management

  • Physical Medicine & Rehabilitation Physician
  • Braintree, MA
  • NPI 1275782435
  NPD (past)

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

{
    "created_epoch": "1127001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1104811900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 VFW PARKWAY",
            "address_2": "VA BOSTON HEALTHCARE SYSTEM",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "02132",
            "telephone_number": "857-203-6931",
            "fax_number": "857-203-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PARKWAY",
            "address_2": "VA BOSTON HEALTHCARE SYSTEM",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "02132",
            "telephone_number": "857-203-6931",
            "fax_number": "857-203-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAUSTEIN",
        "first_name": "DAVID",
        "middle_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-18",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MA",
            "license": "78218",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "78218",
            "primary": false
        },
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "MA",
            "license": "78218",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MA",
            "license": "78218",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MA",
            "license": "78218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer C Bingham, PA
• Edward J Bisaga, RPH
• Stacey B Bishop
• Brittany Blake, LMHC
• Danielle Blanchard, NP
• Julie Blot, M.D.
• Sandra Gay Bock, PA-C, M.ED.
• Claire E Bonafaccia, MSW
• Katherine Bonilla
• Sinthia Bonilla, DPT

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in West Roxbury, MA
• Providers in West Roxbury, MA by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.