Marcia Blacksin, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

25MA05428600 Issued in NJ

Practice address

150 Bergen St
Level C
Newark, NJ 07103-2496

Phone

(973) 972-5188

Fax

(973) 972-2307

NPI assigned

Jul 11, 2006

Last updated

Aug 20, 2009By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• University Physician Associates of New Jersey Inc

  dba University Anesthesia Associates

  • Anesthesiology Physician
  • Newark, NJ
  • NPI 1225048820
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250726400000",
    "number": "1457386344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "address_2": "LEVEL C",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-5188",
            "fax_number": "973-972-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSIN",
        "first_name": "MARCIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2009-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA05428600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0640808",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvonne Elalne Bivins, RN, BSN
• Aynalem Demsis Biza
• Aislinn Denise Black, D.O., M.P.H.
• Emily Black
• Loretta Blacknell
• Lauren Blackwell, MD
• Jennifer Ann Blahuta
• Anthony John Blake, D.C.
• Chantaille Blake
• Sharon A Blake

• Diagnostic Radiology Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Diagnostic Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.