NPIMap

Individual provider Active NPI

Lawrence R Blaty, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Clinton TWP, MI
National Provider Identifier
1235132598
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301407526 Issued in MI
Practice address
43555 Dalcoma Dr
Ste 4
Clinton TWP, MI 48038-6310
Phone
(586) 228-2882
Fax
(586) 463-7152
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301407526 MI Primary

Addresses

Primary practice location

43555 Dalcoma Dr
Ste 4
Clinton TWP, MI 48038-6310

Mailing address

43555 Dalcoma Dr
Ste 4
Clinton TWP, MI 48038-6310
Phone (586) 228-2882

Other identifiers 6

IdentifierTypeStateIssuer
LB407526OtherMIBCBSM
126951OtherMICARE CHOICES-PREFERRED
1792650MedicaidMI
25009724OtherRAILROAD MEDICARE
C6815OtherMIM-CARE
2505006321OtherMIBCN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lblaty476590@ewd.direct.hshs.org Direct St Vincent Hospital-Hospital Sisters-Third Order of St Francis

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI2 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
I20100915000943 MI Practitioner - Physical Medicine and Rehabilitation 3678698552 Reassigns benefits to 1 organization
I20250314000591 WI Practitioner - Physical Medicine and Rehabilitation 3678698552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David S. Weingarden, M.D. and Associates, P.C.Group PAC ID 8426037342, 7 clinicians

Practice addresses (Care Compare)

43555 Dalcoma Dr
Suite 4
Clinton Township, MI 48038-6310
Phone (586) 228-2882

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301407526MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Mar 1, 2025 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Mar 1, 2025 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Mar 1, 2025 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Mar 1, 2025 Accepting new patients
David S. Weingarden, M.D. & Associates, P.C. Physical Medicine & Rehabilitation CurrentSince Sep 1, 1997 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current Accepting new patients
Henry Ford Macomb Hospital Corporation PastSince Sep 1, 1997 Accepting new patients

Locations

43555 Dalcoma Dr
Ste 4
Clinton Twp, MI 48038
Phone (586) 228-2882

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: lblaty250853@direct.hfhs.org
  • Direct secure messaging: lblaty476590@ewd.direct.hshs.org

Organizations & group practices 7

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 12

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1235132598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43555 DALCOMA DR",
            "address_2": "STE 4",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386310",
            "telephone_number": "586-228-2882",
            "fax_number": "586-463-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43555 DALCOMA DR",
            "address_2": "STE 4",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386310",
            "telephone_number": "586-228-2882",
            "fax_number": "586-463-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATY",
        "first_name": "LAWRENCE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301407526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "LB407526",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES-PREFERRED",
            "identifier": "126951",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1792650",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "25009724",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "C6815",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "2505006321",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lblaty476590@ewd.direct.hshs.org",
            "affiliation": "Y",
            "affiliationName": "St Vincent Hospital-Hospital Sisters-Third Order of St Francis",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "835 S Van Buren St",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543013526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.