NPIMap

Individual provider Active NPI

Eli Balshan

  • Anatomic Pathology & Clinical Pathology Physician
  • Philadelphia, PA
National Provider Identifier
1215314554
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD467446 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5189
Phone
(215) 707-4353
Fax
(215) 707-2781
NPI assigned
May 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD467446 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5189

Mailing address

3500 N Broad St
Philadelphia, PA 19140-4106

Other practice location 1

94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone (973) 322-8720

Other names 1

  • Eli Blashkovksy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, 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
I20200303000031 PA Practitioner - Pathology 5799112892 Reassigns benefits to 1 organization
I20220726000688 NY Practitioner - Pathology 5799112892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians
Wyckoff Professional Medical Services PCGroup PAC ID 6406748607, 154 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-5030

374 Stockholm St
Brooklyn, NY 11237-4006
Phone (718) 963-7266

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
  • Wyckoff Heights Medical Center Hospital, Brooklyn, NY, CCN 330221

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD467446PAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Professional Medical Services, PC Anatomic Pathology & Clinical Pathology CurrentSince Mar 2, 2024 Accepting new patients
North Shore-Lij Medical PC CurrentSince May 9, 2022 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Feb 18, 2020 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
North Shore - Lij Medical PC CurrentSince May 9, 2022 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Feb 18, 2020 Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

374 Stockholm St
#13202
Brooklyn, NY 11237
Phone (718) 963-6793

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

900 Franklin Ave
Valley Stream, NY 11580
Phone (516) 256-6000

972 Brush Hollow Rd
Westbury, NY 11590

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

3500 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3656

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

Networks

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

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1215314554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405189",
            "telephone_number": "215-707-4353",
            "fax_number": "215-707-2781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Old Short Hills Rd",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070395672",
            "country_code": "US",
            "telephone_number": "973-322-8720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALSHAN",
        "first_name": "ELI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD467446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELI",
            "last_name": "BLASHKOVKSY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.