Individual provider Active NPI

Elaine Rose Blackman, DO

  • Pediatrics Physician
  • Amsterdam, NY
National Provider Identifier
1710636253
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
337680 Issued in NY
Practice address
4950 State Highway 30
Amsterdam, NY 12010-7520
Phone
(518) 841-3770
Fax
(518) 841-3775
NPI assigned
Mar 22, 2022
Last updated
Jan 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 337680 NY Primary

Addresses

Primary practice location

4950 State Highway 30
Amsterdam, NY 12010-7520

Mailing address

70 Wilkes Ave
Amsterdam, NY 12010-1315
Phone (603) 991-3187

Other practice location 1

427 Guy Park Ave
Amsterdam, NY 12010-1064
Phone (518) 841-3770

Other names 1

  • Elaine Rose Armstrong Former name

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
I20250806002453 NY Practitioner - Pediatric Medicine 8628451283 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Marys Healthcare CurrentSince Sep 8, 2025 Accepting new patients
St. Mary's Healthcare CurrentSince Sep 8, 2025 Accepting new patients
St. Mary's Healthcare Past Accepting new patients

Locations

380 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 841-7415

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

4950 State Highway 30
Amsterdam, NY 12010
Phone (518) 770-7557

Organizations & group practices 3

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": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1710636253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 WILKES AVE",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120101315",
            "telephone_number": "603-991-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 STATE HIGHWAY 30",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107520",
            "telephone_number": "518-841-3770",
            "fax_number": "518-841-3775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "427 Guy Park Ave",
            "address_purpose": "LOCATION",
            "city": "Amsterdam",
            "state": "NY",
            "postal_code": "120101064",
            "country_code": "US",
            "telephone_number": "518-841-3770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "ELAINE",
        "middle_name": "ROSE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "337680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELAINE",
            "last_name": "ARMSTRONG",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Amsterdam, NY

Sources for this page

Verify at the official NPI Registry.