Individual provider Active NPI

David L Bloch, PH.D.

  • Adult Development & Aging Psychologist
  • Middletown, NY
National Provider Identifier
1417028564
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
License
NY010546 Issued in NY
Practice address
52 Grand Ave
Middletown, NY 10940-3925
Phone
(845) 343-1685
Fax
(845) 343-1685
NPI assigned
Nov 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X NY010546 NY
Adult Development & Aging Psychologist 103TA0700X NY010546 NY Primary
Cognitive & Behavioral Psychologist 103TB0200X NY010546 NY
Clinical Psychologist 103TC0700X NY 010546 NY
Clinical Child & Adolescent Psychologist 103TC2200X NY 010546 NY
Forensic Psychologist 103TF0200X NY 010546 NY
Psychologist 103T00000X NY 010546 NY

Addresses

Primary practice location

52 Grand Ave
Middletown, NY 10940-3925

Mailing address

52 Grand Ave
Middletown, NY 10940-3925
Phone (845) 343-1685

Other identifiers 5

IdentifierTypeStateIssuer
110487OtherNYMAGELLAN
1050590OtherNYAFFINITY
V72041OtherNYBLUE CROSS BLUE SHIELD
0015355OtherNYGHI
135316OtherNYVALUE OPTIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150901002147 CA Practitioner - Clinical Psychologist 3971638131 Practice locations: Carlsbad, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2863 Rancho Cortes
Carlsbad, CA 92009-3035
Phone (760) 585-5080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NY010546NYMDAdult Development & Aging Psychologist
NY 010546NYMDClinical Child & Adolescent Psychologist
010546NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417028564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 GRAND AVE",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109403925",
            "telephone_number": "845-343-1685",
            "fax_number": "845-343-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 GRAND AVE",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109403925",
            "telephone_number": "845-343-1685",
            "fax_number": "845-343-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCH",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "NY010546",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "NY010546",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "NY010546",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "NY 010546",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "NY 010546",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NY",
            "license": "NY 010546",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "NY 010546",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "110487",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AFFINITY",
            "identifier": "1050590",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "V72041",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0015355",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "135316",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.