Individual provider Active NPI

Ilyse Blazar, DO

  • Surgery Physician
  • Hawthorne, NY
National Provider Identifier
1679192801
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
341510 Issued in NY
Practice address
19 Bradhurst Ave Ste 25575S
Hawthorne, NY 10532-2140
Phone
(914) 909-6416
NPI assigned
Apr 8, 2020
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 341510 NY Primary

Addresses

Primary practice location

19 Bradhurst Ave Ste 25575S
Hawthorne, NY 10532-2140

Mailing address

19 Bradhurst Ave Ste 2575S
Hawthorne, NY 10532-2140
Phone (914) 909-6416

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ilyse.blazar@wmchealth.cenerdirect.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260429000268 NY Practitioner - General Surgery 7517434400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

19 Bradhurst Ave
Hawthorne, NY 10532-2139

19 Bradhurst Ave
Suite 3100N
Hawthorne, NY 10532-2140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
341510NYMDSurgery Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1679192801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 2575S",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-909-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 25575S",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-909-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZAR",
        "first_name": "ILYSE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-08",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "341510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ilyse.blazar@wmchealth.cenerdirect.com",
            "affiliation": "N",
            "endpointDescription": "APS Surgery",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "19 Bradhurst Ave Ste 25575S",
            "city": "Hawthorne",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105322140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.