Active NPI
Sean Michael Blackledge, PHARMD
- Pharmacist
- New York, NY
National Provider Identifier
1538624663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 79706
- Practice address
- 358 5TH Ave
New York, NY 10001-2209 - Phone
- (212) 824-5050
- NPI assigned
- Feb 3, 2019
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 79706 | CA | Primary |
Addresses
Primary practice location
358 5TH Ave
New York, NY 10001-2209
Mailing address
358 5TH Ave
New York, NY 10001-2209
Phone (636) 352-9920
Other practice location 1
801 East Ave
Chico, CA 95926-1250
Phone (636) 352-9920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79706 | Other | CA | CALIFORNIA BOARD OF PHARMACY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614729600000",
"number": "1538624663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "358 5TH AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100012209",
"telephone_number": "636-352-9920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "358 5TH AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100012209",
"telephone_number": "212-824-5050"
}
],
"practiceLocations": [
{
"address_1": "801 East Ave",
"address_purpose": "LOCATION",
"city": "Chico",
"state": "CA",
"postal_code": "959261250",
"country_code": "US",
"telephone_number": "636-352-9920",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLACKLEDGE",
"first_name": "SEAN",
"middle_name": "MICHAEL",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-03",
"last_updated": "2021-03-03",
"certification_date": "2021-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "79706",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF PHARMACY",
"identifier": "79706",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.