Derek Martin Blevins, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

288318 Issued in NY

Practice address

110 E 60TH St RM 900
New York, NY 10022-1697

Phone

(914) 340-4535

Fax

(385) 355-2734

NPI assigned

Mar 29, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 25, 2021 through Feb 25, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1720321565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E 56TH ST RM 300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223753",
            "telephone_number": "914-340-4535",
            "fax_number": "385-355-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 60TH ST RM 900",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221697",
            "telephone_number": "914-340-4535",
            "fax_number": "385-355-2734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 Riverside Dr Unit 66",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100321007",
            "country_code": "US",
            "telephone_number": "646-774-6133",
            "fax_number": "385-355-2734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "DEREK",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-29",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NY",
            "license": "288318",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "288318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Bleicher
• Ashley Bleser
• Marcelle E Blessing, MD
• Jewel Bletcher, LPN
• Bleu Health Sports Chiropractic P C
• Jason Blevins, MD
• Kaitlin Blevins, LCSW
• Lindsay Anne Blevins, PH.D.
• Jenna Blewis, PSY.D.
• Amy B Bleyer, MD

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.