Robin Madonna Blaize

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F404761 Issued in NY

Practice address

3425 Vernon Blvd
Astoria, NY 11106-5121

Phone

(844) 815-1508

NPI assigned

Jan 21, 2022

Last updated

Jul 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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: No

Green means eligible to order or refer.

Enrollment records 1

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.

• Housing Works Health Services III, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1114950151
  Medicare reassignment NPD

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1639821598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 BEACH 32ND ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911933",
            "telephone_number": "347-933-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 VERNON BLVD",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111065121",
            "telephone_number": "844-815-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIZE",
        "first_name": "ROBIN",
        "middle_name": "MADONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "755337",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F404761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Koomlee Bimka, R.N. B.S,N
• Josh Bismuth
• BL Pain Management PLLC
• Malgorzata Bladek, RN
• Myriam Blain-Nicolas, RPA
• Wendy Jill Blank, OTR/L
• Walter Robert Blick, MS, OTR/L
• Gabrielle Block
• Leora Blond, PA-C
• Blossom Home Care LLC

• Psychiatric/Mental Health Nurse Practitioner in Astoria, NY
• Providers in Astoria, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.