Charles J Bleifeld, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

103836-1 Issued in NY

Practice address

48 Route 25a
Suite 106
Smithtown, NY 11787-1431

Phone

(631) 863-1007

Fax

(631) 862-3668

NPI assigned

Jul 24, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1639191968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 ROUTE 25A",
            "address_2": "SUITE 106",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871431",
            "telephone_number": "631-863-1007",
            "fax_number": "631-862-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 ROUTE 25A",
            "address_2": "SUITE 106",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871431",
            "telephone_number": "631-863-1007",
            "fax_number": "631-862-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEIFELD",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "103836-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "446211",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bizeta Medical Office PC
• Nicolae Dragos Bizeta, MD
• Carin Jean Blackstone, P.T.
• Theodore Blaszczyk, M.D.
• Daniel Allan Bleecher, LMHC-D
• Deborah Blenner, M.D.
• Jeffrey Michael Block, D.C.
• Richard Steven Block, D.C.
• David N Bloomberg, LCSW-R
• Nathan Blumberg, M.D.

• Specialist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.