Blake Samuel Feldman, AGNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP025161 Issued in PA

Practice address

3900 Woodland Ave
Philadelphia, PA 19104-4551

Phone

(215) 823-5800

Fax

(215) 823-4234

NPI assigned

Apr 8, 2022

Last updated

Apr 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1518609734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 DICKINSON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464848",
            "telephone_number": "954-873-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044551",
            "telephone_number": "215-823-5800",
            "fax_number": "215-823-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "BLAKE",
        "middle_name": "SAMUEL",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-08",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP025161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Lee Felder
• Alison Leigh Feldman, M.S., CCC-SLP
• Arthur M Feldman, MD
• Arthur M. Feldman, M.D.
• Avigad Feldman, NP-C
• Boris David Feldman, PHARMD
• Brad H Feldman, MD
• Debra S Feldman, MD
• Harold I Feldman, MD
• Hope Feldman, CRNP

• Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.