Ksenia Nikolayevna Blinnikova, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1013709 Issued in MA

Practice address

50 Staniford St FL 9
Boston, MA 02114-2506

Phone

(612) 724-6610

NPI assigned

Jan 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, MA2 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

Specialty

Family Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
• Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
• Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
• North Shore Medical Center - Hospital, Salem, MA, CCN 220035
• Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075
• Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119
• Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kblinnikova@direct.uabmedicine.org
• Direct secure messaging: blinnikova.ksenia.mgh@direct.partners.masshiway.net

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.

• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573
  Medicare reassignment Care Compare group NPD
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Medicare reassignment NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment
• General Hospital Corp

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1508390014
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mass General Brigham Home Care, Inc.

  • Home Health Agency
  • Newton, MA
  • NPI 1083644017
  Care Compare affiliation Name & address match
• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation
• Brigham and Women'S Faulkner Hospital, Inc

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1578677811
  Care Compare affiliation
• Brigham and Women'S Faulkner Hospital, Inc.

  • Psychiatric Hospital Unit
  • Boston, MA
  • NPI 1033121025
  Care Compare affiliation
• Massachusetts Eye and Ear Infirmary

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1639101751
  Care Compare affiliation
• North Shore Medical Center, Inc.

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Care Compare affiliation
• The Spaulding Rehabilitation Hospital Corporation

  • Rehabilitation Hospital
  • Charlestown, MA
  • NPI 1780600825

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1740646181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 STANIFORD ST FL 9",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142506",
            "telephone_number": "614-724-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 STANIFORD ST FL 9",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142506",
            "telephone_number": "612-724-6610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 11th Ave S Ste 410",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352053423",
            "country_code": "US",
            "telephone_number": "205-934-9700",
            "fax_number": "205-975-6962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLINNIKOVA",
        "first_name": "KSENIA",
        "middle_name": "NIKOLAYEVNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2023-08-01",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "AL",
            "license": "37486",
            "primary": false
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "MA",
            "license": "1013709",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "1013709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Grace Blewett, LCSW
• Daniel James Bley, DDS
• Varvara Blidman, DMD
• Mathew Bligh, MD
• Russell Alan Blinder, M.D.
• Cayley Bliss, M.A.
• Charles M. Bliss Jr., MD
• Blissful, LLC
• Sarah Blitz, MD
• Donald B Bloch, MD

• Family Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.