Active NPI
David L Blecker, MD
- Nephrology Physician
- Northfield, NJ
National Provider Identifier
1245249473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- MA 34493
- Practice address
- 510 Jackson Ave
Northfield, NJ 08225 - Phone
- (609) 303-0200
- Fax
- (609) 383-8352
- NPI assigned
- Aug 5, 2006
- Last updated
- Feb 28, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | MA 34493 | NJ | Primary |
Addresses
Primary practice location
510 Jackson Ave
Northfield, NJ 08225
Mailing address
510 Jackson Ave
Northfield, NJ 08225
Phone (609) 303-0200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3787508 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA 34493 | NJ | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Kidney Care LLC | Nephrology | Past | Accepting new patients |
| Kidney and Hypertension Specialists, P.a. | Nephrology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Nephrology Physician
- Bridgeton, NJ
- NPI 1538198486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298851200000",
"number": "1245249473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 JACKSON AVE",
"city": "NORTHFIELD",
"state": "NJ",
"postal_code": "08225",
"telephone_number": "609-303-0200",
"fax_number": "609-383-8352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 JACKSON AVE",
"city": "NORTHFIELD",
"state": "NJ",
"postal_code": "08225",
"telephone_number": "609-303-0200",
"fax_number": "609-383-8352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLECKER",
"first_name": "DAVID",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2011-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NJ",
"license": "MA 34493",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3787508",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Northfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.