NPIMap

Individual provider Active NPI

Allen Jay Blaivas, DO

  • Pulmonary Disease Physician
  • New York, NY
National Provider Identifier
1104830397
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MB07222400 Issued in NJ
Practice address
1111 Amsterdam Ave
New York, NY 10025-1716
Phone
(212) 523-4000
NPI assigned
Jul 27, 2006
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 236102 NY
Pulmonary Disease Physician 207RP1001X 25MB07222400 NJ Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 236102 NY
Pulmonary Disease Physician 207RP1001X 236102 NY

Addresses

Primary practice location

1111 Amsterdam Ave
New York, NY 10025-1716

Mailing address

44 Barry PL
Passaic, NJ 07055-3516

Other practice location 1

1000 10th Ave
New York, NY 10019-1147
Phone (212) 523-4000

Other practice location 2

385 Tremont Ave # 561/111
East Orange, NJ 07018-1023
Phone (973) 676-1000 ext. 1220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110202000348 NJ Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Other (Physician) 9234319666 Reassigns benefits to 2 organizations
I20110920000833 NY Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 9234319666 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease, Sleep Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Care Medical Group PLLCGroup PAC ID 7113298209, 45 clinicians

Practice addresses (Care Compare)

150 Riverside Dr
New York, NY 10024-2298
Phone (646) 505-3500

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5045

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236102NYMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Critical Care Medicine CurrentSince Feb 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2020 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Progressive Care Medical Group, PLLC Internal Medicine CurrentSince Sep 19, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai Critical Care Medicine CurrentSince Jun 4, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 4, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
150 Riverside Op. LLC Past Accepting new patients
Nydh Physician Practice Internal Medicine Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

200 Old Country Rd
Mineola, NY 11501
Phone (516) 408-4900

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

150 Eileen Way
Unit 1
Syosset, NY 11791
Phone (516) 855-5255

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: allen.blaivas@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 11

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 6

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1104830397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 BARRY PL",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070553516",
            "fax_number": "973-395-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 10th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191147",
            "country_code": "US",
            "telephone_number": "212-523-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "385 Tremont Ave # 561/111",
            "address_purpose": "LOCATION",
            "city": "East Orange",
            "state": "NJ",
            "postal_code": "070181023",
            "country_code": "US",
            "telephone_number": "973-676-1000 x1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIVAS",
        "first_name": "ALLEN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "236102",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MB07222400",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "236102",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "236102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.