Individual provider Active NPI

Joseph Blood, PAC

  • Physician Assistant
  • Ithaca, NY
National Provider Identifier
1679501811
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008608 Issued in NY
Practice address
101 Dates Dr
Ithaca, NY 14850-1342
Phone
(607) 274-4011
Fax
(607) 274-4132
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 008608 NY Primary

Addresses

Primary practice location

101 Dates Dr
Ithaca, NY 14850-1342

Mailing address

763 S Main St
Athens, PA 18810-1009
Phone (570) 888-0239

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061102000083 NY Practitioner - Physician Assistant 8022056241 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8608NYMDOptician
008608NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Port City Emergency Physicians LLP Physician Assistant CurrentSince Sep 7, 2016 Accepting new patients
Port City Emergency Physicians LLP Physician Assistant CurrentSince Sep 7, 2016 Accepting new patients
Cayuga Emergency Physicians, LLP CurrentSince Apr 1, 2017 Accepting new patients
Arnot Ogden Medical Center Past Accepting new patients
Robert Packer Hospital Past Accepting new patients

Locations

75 Remit Dr
Chicago, IL 60675

1129 Commons Ave
#C
Cortland, NY 13045
Phone (607) 339-0456

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

Interoperability endpoints

  • Direct secure messaging: jblood7781@direct-guthrie.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1679501811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 S MAIN ST",
            "city": "ATHENS",
            "state": "PA",
            "postal_code": "188101009",
            "telephone_number": "570-888-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501342",
            "telephone_number": "607-274-4011",
            "fax_number": "607-274-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOD",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.