Individual provider Active NPI

Noel Edwin Blackman, MD

  • Surgery Physician
  • Valley Stream, NY
National Provider Identifier
1720209521
Registry record updated Jan 17, 2014
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(4) exclusion effective Dec 20, 2017.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
141896 Issued in NY
Practice address
83 Law St
Valley Stream, NY 11580
Phone
(718) 528-6277
Fax
(516) 285-4949
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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 141896 NY Primary

Addresses

Primary practice location

83 Law St
Valley Stream, NY 11580

Mailing address

83 Law St
Valley Stream, NY 11580
Phone (516) 263-8123

Other identifiers 1

IdentifierTypeStateIssuer
00825810MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Citywide Family Practice Medical, P.C. Past Accepting new patients
A & V Medical Associates, P.C. Past Accepting new patients
Dolce Billing and Corporate Services, Inc. Past Accepting new patients
Every Boro Ambulette Serv Inc Past Accepting new patients

Organizations & group practices 4

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1720209521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 LAW ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-263-8123",
            "fax_number": "516-285-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 LAW ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "718-528-6277",
            "fax_number": "516-285-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "NOEL",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "141896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00825810",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.