Jeffrey C Blum, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV004648 Issued in NY

Practice address

56 Reynolds Dr
Lido Beach, NY 11561-4928

Phone

(516) 361-3364

Fax

(516) 889-0337

NPI assigned

Nov 1, 2006

Last updated

Jul 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empire Vision Center Inc

  dba Davis Vision

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  NPD
• Empire Vision Center, Inc

  dba Visionworks

  • Eyewear Supplier
  • Attleboro, MA
  • NPI 1730635582
  NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1588741052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 REYNOLDS DR",
            "city": "LIDO BEACH",
            "state": "NY",
            "postal_code": "115614928",
            "telephone_number": "516-889-0337",
            "fax_number": "516-889-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 REYNOLDS DR",
            "city": "LIDO BEACH",
            "state": "NY",
            "postal_code": "115614928",
            "telephone_number": "516-361-3364",
            "fax_number": "516-889-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Axelrod, DC, LAC
• Elana Axelrod, LCSW
• Chana Baumann, FNP
• Martina Petra Beloyianis, SLP
• Adena Berkowitz, DHL, LP
• Brookville Center for Childrens Services Inc
• Brookville Center for Childrens Services Inc
• Brookville Center for Childrens Services Inc
• Shelly Cepeda, LCSW
• Jamie Tedesco Cohen

• Optometrist in Lido Beach, NY
• Providers in Lido Beach, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.