Individual provider Active NPI

Jordan Blinder, MD

  • Anesthesiology Physician
  • Springfield, MA
National Provider Identifier
1306836135
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
73965 Issued in MA
Practice address
908 Allen St
Springfield, MA 01118-2533
Phone
(413) 796-7494
Fax
(413) 796-7497
NPI assigned
Oct 24, 2005
Last updated
Apr 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 73965 MA Primary

Addresses

Primary practice location

908 Allen St
Springfield, MA 01118-2533

Mailing address

908 Allen St
Springfield, MA 01118-2533
Phone (413) 796-7494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070208000092 CT Practitioner - Anesthesiology 5496792087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Boston University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Anesthesia Associates LLCGroup PAC ID 1759281165, 402 clinicians

Practice addresses (Care Compare)

65 Memorial Rd
Suite 500
West Hartford, CT 06107-4233
Phone (860) 586-8655

80 Semour St
Hartford, CT 06106-3315
Phone (860) 972-2117

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73965MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Anesthesia Associates LLC Anesthesiology CurrentSince Jul 1, 2014 Accepting new patients
Springfield Anesthesia Service, Inc. Anesthesiology Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06032
Phone (860) 679-1706

263 Farmington Ave
#6305
Farmington, CT 06032

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

505 Willard Ave
Newington, CT 06111
Phone (860) 224-6709

2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375

2 Trap Falls Rd
Ste 414
Shelton, CT 06484
Phone (203) 282-4128

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.

Hospital & facility affiliations 4

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1306836135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 ALLEN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011182533",
            "telephone_number": "413-796-7494",
            "fax_number": "413-796-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 ALLEN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011182533",
            "telephone_number": "413-796-7494",
            "fax_number": "413-796-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLINDER",
        "first_name": "JORDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "73965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.