Edward Blackman, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

G49755 Issued in CA

Practice address

215 W Janss Road
Thousand Oaks, CA 91360

Phone

(805) 373-8582

Fax

(805) 373-6865

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

94.4 of 100Reported as group

Quality

93.25

Improvement activities

40

Cost

79.74

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Glover Kelty and Schultheis M DS

  • Anatomic Pathology & Clinical Pathology Physician
  • Thousand Oaks, CA
  • NPI 1245263243
  NPD
• Thousand Oaks Pathology Associates Inc a Medical Group

  dba Thousand Oaks Pathology Associates Inc

  • Clinical Medical Laboratory
  • Thousand Oaks, CA
  • NPI 1912930900
  NPD

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1215903455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 LYNN RD",
            "address_2": "STE 220",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91360",
            "telephone_number": "805-495-8050",
            "fax_number": "805-496-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W JANSS ROAD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91360",
            "telephone_number": "805-373-8582",
            "fax_number": "805-373-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G49755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G497750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Biomechanics Physical Therapy, P.C.
• Birch Baby LLC (Birch Family Birth Services)
• Chirag Bisht, MD
• Bita Z. Farrell, M.D., Inc.
• Andrea Bitar
• Justin Blada, L.M.T.
• Rachel Christine Blakely
• Steven Bryan Blakely
• Sheila Ann Blanchfield, MFT
• Jason Blanton, LMFT

• Anatomic Pathology & Clinical Pathology Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.