Dominique Blume

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA061380 Issued in PA

Practice address

5230 Centre Ave
3Rd Floor
Pittsburgh, PA 15232-1304

Phone

(412) 864-7587

NPI assigned

Jan 9, 2020

Last updated

Jun 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Margaret S. Lally, LLC

  • Dermatology Physician
  • Pittsburgh, PA
  • NPI 1144409434
  Medicare reassignment

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1205476009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 CENTRE AVE FL 3",
            "address_2": "3RD FLOOR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 CENTRE AVE",
            "address_2": "3RD FLOOR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321304",
            "telephone_number": "412-864-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUME",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2021-06-15",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA061380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blue Diamond Group Home LLC
• Blue Feather Therapy LLC
• Amber Blue
• Blueberry Pharmacy
• Bluebird Psychotherapy and Wellness
• Bennett Blumenkopf, MD
• Hendel Blumenkrantz
• Alexandra Dawn Blumer, MD
• Steven Lonnie Blumer, MD
• Amber Renee Blumling, DNP, FNP-C

• Medical Physician Assistant in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.