Susan M Blatt, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

127636 Issued in NY

Practice address

406 Elizabeth St
Utica, NY 13501-2306

Phone

(315) 798-5747

Fax

(315) 798-1057

NPI assigned

Oct 5, 2006

Sex

Female

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Charles T. Sitrin Health Care Center, Inc

  • Skilled Nursing Facility
  • New Hartford, NY
  • NPI 1770589251

  Corporate Director

  CMS ownership

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.

• County of Oneida

  • Public Health or Welfare Agency
  • Utica, NY
  • NPI 1841329737

  NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1619064490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135012102",
            "telephone_number": "315-798-5080",
            "fax_number": "315-798-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 ELIZABETH ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135012306",
            "telephone_number": "315-798-5747",
            "fax_number": "315-798-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATT",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "127636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Black Drugs Inc
• Sandra Jo Black
• Ashley A. Blanchard, NP
• Lisa Blanchfield, PSYD
• Brianna Blancovich, BCBA
• Dennis Blom, MD
• Jaime Michelle Blum, FNP
• Bobs Pharmacy LLC
• Bobs Pharmacy LLC
• Bodywise Pure Pilates, LLC

• All providers in Utica, NY
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.