Individual provider Active NPI

Bliz Babu George, PA

  • Physician Assistant
  • Yonkers, NY
National Provider Identifier
1396357752
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
45 Canfield Ave
Yonkers, NY 10710-1906
Phone
(914) 793-1175
NPI assigned
Aug 18, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

45 Canfield Ave
Yonkers, NY 10710-1906

Mailing address

45 Canfield Ave
Yonkers, NY 10710-1906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230601001275 NY Practitioner - Physician Assistant 9436516762 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Apr 22, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Apr 22, 2023 Accepting new patients

Locations

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: bgeorge1@montefioredirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1396357752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CANFIELD AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107101906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CANFIELD AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107101906",
            "telephone_number": "914-793-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "BLIZ",
        "middle_name": "BABU",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.