Active NPI
David L Bloch, PH.D.
- Adult Development & Aging Psychologist
- Middletown, NY
National Provider Identifier
1417028564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Development & Aging Psychologist
- License
- NY010546
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110487 | Other | NY | MAGELLAN |
| 1050590 | Other | NY | AFFINITY |
| V72041 | Other | NY | BLUE CROSS BLUE SHIELD |
| 0015355 | Other | NY | GHI |
| 135316 | Other | NY | VALUE 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| NY010546 | NY | MD | Adult Development & Aging Psychologist |
| NY 010546 | NY | MD | Clinical Child & Adolescent Psychologist |
| 010546 | NY | MD | Physical 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.