Active NPI
Gerald W Blackburn, DO
- Infectious Disease Physician
- Farmington Hills, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 5101006566
- Practice address
- 28080 Grand River Ave Ste 306
Farmington Hills, MI 48336-5966 - Phone
- (947) 521-8314
- Fax
- (248) 478-8864
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 5101006566 | MI | Primary |
Addresses
Primary practice location
28080 Grand River Ave Ste 306
Farmington Hills, MI 48336-5966
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gblackburn96482@direct.beaumont.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Infectious Disease
- Education
- Midwestern University, Chicago College of Osteopathic Med, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (947) 521-8000
28080 Grand River Ave
Suite 306N
Farmington Hills, MI 48336-5966
Phone (947) 521-4771
28100 Grand River Ave
Farmington Hills, MI 48336-5970
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.37 of 100
- Quality
- 66.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaumont Medical Group- Specialty Services | Current | Accepting new patients |
Locations
28080 Grand River Ave
Ste 306
Farmington Hills, MI 48336
Phone (248) 471-8982
28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320
28080 Grand River Ave
Ste 306N
Farmington Hills, MI 48336
Phone (947) 521-4771
28711 8 Mile Rd
Ste B
Livonia, MI 48152
Phone (248) 482-8830
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860
Interoperability endpoints
- gblackburn1225833@epic00.shdirect.org
Organizations & group practices 1
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.
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1477597326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28080 GRAND RIVER AVE STE 306",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483365966",
"telephone_number": "947-521-8314",
"fax_number": "248-478-8864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "GERALD",
"middle_name": "W",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "MI",
"license": "5101006566",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gblackburn96482@direct.beaumont.edu",
"affiliation": "N",
"address_1": "28080 Grand River Ave Ste 306",
"city": "Farmington Hills",
"state": "MI",
"country_code": "US",
"postal_code": "483365966",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.