Individual provider Active NPI

Robin Leigh Pavlich Blackstone, MD

  • Surgery Physician
  • New York, NY
National Provider Identifier
1720099401
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
193552 Issued in NY
Practice address
15 E 26TH St Apt 11D
New York, NY 10010-1443
Phone
(602) 549-6790
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 24199 AZ
Surgery Physician 208600000X 193552 NY Primary

Addresses

Primary practice location

15 E 26TH St Apt 11D
New York, NY 10010-1443

Mailing address

15 E 26TH St Apt 11D
New York, NY 10010-1443
Phone (602) 549-6790

Other names 1

  • Robin Pavlich Staerkel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040426001560 AZ Practitioner - General Surgery 6901710326 Reassigns benefits to 1 organization
I20180521001335 TX Practitioner - General Surgery 6901710326 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24199AZMDSurgery Physician
193552NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Ambulatory CurrentSince Apr 1, 2010 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Apr 9, 2018 Accepting new patients
Honorhealth Ambulatory Current Accepting new patients
San Carlos Apache Healthcare Corporation Current Accepting new patients
Scottsdale Healthcare Corp CurrentSince Apr 1, 2010 Accepting new patients
Scottsdale Bariatric Center PastSince Jan 1, 2002 Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

Organizations & group practices 6

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1720099401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 E 26TH ST APT 11D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101443",
            "telephone_number": "602-549-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E 26TH ST APT 11D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101443",
            "telephone_number": "602-549-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTONE",
        "first_name": "ROBIN",
        "middle_name": "LEIGH PAVLICH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "24199",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "193552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "STAERKEL",
            "middle_name": "PAVLICH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.