NPIMap

Individual provider Active NPI

Mark L Blitzer, M.D.

  • Cardiovascular Disease Physician
  • New Haven, CT
National Provider Identifier
1164428207
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
037730 Issued in CT
Practice address
330 Orchard St.
Suite 210
New Haven, CT 06511-4429
Phone
(203) 867-5400
Fax
(203) 867-5401
NPI assigned
Jun 23, 2005
Last updated
Jul 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 037730 CT
Cardiovascular Disease Physician 207RC0000X 037730 CT Primary
Specialist 174400000X

Addresses

Primary practice location

330 Orchard St.
Suite 210
New Haven, CT 06511-4429

Mailing address

330 Orchard St.
Suite 210
New Haven, CT 06511-4429
Phone (203) 867-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20040908000730 CT Practitioner - Cardiovascular Disease (Cardiology) 7214903582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Harvard Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

79 Wawecus St
Suite 106
Norwich, CT 06360-2173
Phone (860) 886-8673

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
037730CTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jul 1, 2020 Accepting new patients
Yale University CurrentSince Jul 1, 2020 Accepting new patients

Locations

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

79 Wawecus St
Ste 106
Norwich, CT 06360
Phone (860) 886-2679

Interoperability endpoints

  • Direct secure messaging: mblitzer2566@direct.ynhh.org

Organizations & group practices 2

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 7

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1164428207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 ORCHARD ST.",
            "address_2": "SUITE 210",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114429",
            "telephone_number": "203-867-5400",
            "fax_number": "203-867-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ORCHARD ST.",
            "address_2": "SUITE 210",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114429",
            "telephone_number": "203-867-5400",
            "fax_number": "203-867-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLITZER",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "037730",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "037730",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.