Cheryl Blaivas, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

225 Eastview Dr
Central Islip, NY 11722-4539

Phone

(631) 665-1600

NPI assigned

Dec 7, 2021

Last updated

Dec 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, MA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mill Basin Medical Health PCGroup PAC ID 9133566128, 104 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Mill Basin Medical Health PC

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  • Brooklyn, NY
  • NPI 1346006202
  Medicare reassignment Care Compare group
• Nys Medical Associate PLLC

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  • NPI 1104268572
  Medicare reassignment
• Ma SNF on Call PLLC

  • Internal Medicine Physician
  • Fall River, MA
  • NPI 1629938790
  Medicare reassignment

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1437817319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WHITE DR",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 EASTVIEW DR",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224539",
            "telephone_number": "631-665-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIVAS",
        "first_name": "CHERYL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cedarhurst",
            "affiliation": "N",
            "address_1": "225 Eastview Dr",
            "city": "Central Islip",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117224539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah M Billups, R031395
• Bird by Bird Counseling LCSW PC
• Kim Denise Bjorklund, LMSW
• Abisha Blair
• Stay SC Blair
• Mariah Boccabella
• Kenesha Bogle, RN
• Lynn Ellen Boniecki Savino, PT
• Keshia Latoya Boodie, LPN
• Denese Booker, BSN, RN

• Physician Assistant in Central Islip, NY
• Providers in Central Islip, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.

Verify at the official NPI Registry.