NPIMap

Individual provider Active NPI

Blaze D Emerson, DO

  • Orthopaedic Surgery of the Spine Physician
  • Port St Lucie, FL
National Provider Identifier
1568987014
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
OS19620 Issued in FL
Practice address
7710 S US Highway 1
Port St Lucie, FL 34952-2320
Phone
(772) 335-5300
Fax
(772) 200-2131
NPI assigned
Aug 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X OS19620 FL Primary

Addresses

Primary practice location

7710 S US Highway 1
Port St Lucie, FL 34952-2320

Mailing address

7710 S US Highway 1
Port St Lucie, FL 34952-2320
Phone (772) 335-5300

Other practice location 1

2221 SE Ocean Blvd Ste 200
Stuart, FL 34996-3341
Phone (772) 283-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230703001908 FL Practitioner - Orthopedic Surgery 6901280460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Nova Southeastern College of Osteo Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Orthopaedics and Sports Medicine CenterGroup PAC ID 5294728465, 16 clinicians

Practice addresses (Care Compare)

7710 S US Hwy 1
Port St Lucie, FL 34952-2320
Phone 77233553002015

Hospital & facility affiliations

  • The Roads Home Health Palm Beach Home health agency, West Palm Beach, FL, CCN 109344
  • Haven Home Health Care Home health agency, Boca Raton, FL, CCN 103153
  • Trilogy Home Healthcare Home health agency, Port Saint Lucie, FL, CCN 109270
  • St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260
  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
  • HCA Florida Lawnwood Hospital Hospital, Fort Pierce, FL, CCN 100246

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion49
Laminectomy or laminotomy (partial removal of spine bones)12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS19620FLMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopaedics & Sports Medicine Center CurrentSince Aug 1, 2023 Accepting new patients
Coastal Orthopaedics & Sports Medicine Center Orthopaedic Surgery CurrentSince Aug 1, 2023 Accepting new patients

Locations

7710 S US Highway 1
Port St Lucie, FL 34952
Phone (772) 335-5300

2221 SE Ocean Blvd
Ste 200
Stuart, FL 34996
Phone (772) 219-4096

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: blazeemerson@cos.directglo.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1501977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1568987014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349522320",
            "telephone_number": "772-335-5300",
            "fax_number": "772-200-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349522320",
            "telephone_number": "772-335-5300",
            "fax_number": "772-200-2131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2221 SE Ocean Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349963341",
            "country_code": "US",
            "telephone_number": "772-283-5500",
            "fax_number": "772-200-2131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "BLAZE",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-06",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "FL",
            "license": "OS19620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.