Supriya Blair, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021718 Issued in NY

Practice address

1 Ten Broeck St Ste 1
Albany, NY 12210-2521

Phone

(518) 501-0092

NPI assigned

Jul 24, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• 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 Jan 11, 2017 through Jan 11, 2027

Medicare enrollment (NPD)

Not 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.

• Saratoga Psychiatric and Associated Services PC

  • Psychiatry Physician
  • Saratoga Springs, NY
  • NPI 1245414168

  Clinical

  NPD (past)

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

{
    "created_epoch": "1469318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1366995508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TEN BROECK ST STE 1",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122102521",
            "telephone_number": "518-501-0092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TEN BROECK ST STE 1",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122102521",
            "telephone_number": "518-501-0092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Geyser Rd",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128669069",
            "country_code": "US",
            "telephone_number": "518-583-3035 x209",
            "fax_number": "518-583-4247",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "516 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Rensselaer",
            "state": "NY",
            "postal_code": "121441437",
            "country_code": "US",
            "telephone_number": "518-583-3035 x269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "SUPRIYA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-24",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Black
• Amy Jo Blackford, MS
• Joann Blair, RN
• Lauren Judith Blair, NP
• Michelle Marie Blair, CCC-SLP
• Megan Blake
• Cathy Anne Blanchard-Diegel, MS TSHH
• Anne R Blanchard, RPH
• Carrie Ann Blanchard, LCSW
• Deborah Blanchard

• Clinical Psychologist in Albany, NY
• Providers in Albany, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.