Individual provider Active NPI

Nicholson P. Blaise

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1205713690
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
357677 Issued in NY
Practice address
325 E 32ND St
Brooklyn, NY 11226-7905
Phone
(508) 930-3030
NPI assigned
Aug 19, 2025
Last updated
Aug 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 357677 NY Primary

Addresses

Primary practice location

325 E 32ND St
Brooklyn, NY 11226-7905

Mailing address

325 E 32ND St
Brooklyn, NY 11226-7905

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251029001311 NY Practitioner - Nurse Practitioner 8729577887 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1371 Seabury Ave
Bronx, NY 10461-3651
Phone (718) 618-0401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
357677NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronx Medical Practice P.C. CurrentSince Aug 22, 2025 Accepting new patients
Essen Medical Associates, PC CurrentSince Aug 22, 2025 Accepting new patients
Essen Medical Associates, PC CurrentSince Aug 22, 2025 Accepting new patients
Essen Medical Urgicare, PLLC CurrentSince Aug 22, 2025 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Aug 22, 2025 Accepting new patients

Locations

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

Networks

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1205713690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E 32ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112267905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E 32ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112267905",
            "telephone_number": "508-930-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISE",
        "first_name": "NICHOLSON",
        "middle_name": "P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "357677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.