Zachary Kalman Blumkin, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

019728 Issued in NY

Practice address

23 Central Ave
Lynn, MA 01901-1220

Phone

(781) 477-7222

Fax

(781) 598-8137

NPI assigned

Dec 5, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 11, 2015 through Oct 11, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lynn Community Health, Inc.

  • Health Service Clinic/Center
  • Lynn, MA
  • NPI 1912215120
  NPD (past)

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1255576153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011314",
            "telephone_number": "781-477-7222",
            "fax_number": "781-598-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CENTRAL AVE",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011220",
            "telephone_number": "781-477-7222",
            "fax_number": "781-598-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMKIN",
        "first_name": "ZACHARY",
        "middle_name": "KALMAN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-05",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "019728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dean Alan Blass, M.D.
• Lawrence S Block, MD
• Kara Bloomingdale, MSN, PMHCNS-BC
• Melanie C Blount, PSY.D
• Blue Star Ventures LLC.
• Jordan Bodwell, LMHC
• Ian Joseph Boehm Jr., DC
• Elise Bognanno, MD
• Alicia Marie Boisson
• Denise Boisvert, NP

• Psychologist in Lynn, MA
• Providers in Lynn, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.