Active NPI
Carol Blaisdell, M.D.
- Pediatric Pulmonology Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- MD482909
- Practice address
- 160 E Erie Ave
Philadelphia, PA 19134-1011 - Phone
- (215) 427-5085
- NPI assigned
- May 23, 2006
- Last updated
- Nov 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pulmonology Physician | 2080P0214X | D4210 | MD | |
| Pediatric Pulmonology Physician | 2080P0214X | MD482909 | PA | Primary |
Addresses
Primary practice location
160 E Erie Ave
Philadelphia, PA 19134-1011
Mailing address
PO Box 62063
Baltimore, MD 21264-2063
Phone (410) 706-5181
Other practice location 1
22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 706-5181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 302691400 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D4210 | MD | MD | Pediatric Pulmonology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| STC Pediatrics LLC | Current | Accepting new patients | |
| Johns Hopkins University | Pediatric Pulmonology | Current | Accepting new patients |
| Johns Hopkins University | Current | Accepting new patients | |
| STC Pediatrics LLC | Current | Accepting new patients | |
| STC Pediatrics LLC | Pediatric Pulmonology | Current | Accepting new patients |
| Johns Hopkins University | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| The Johns Hopkins Hospital | Past | Accepting new patients |
Locations
600 N Wolfe St
Baltimore, MD 21287
601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080
6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704
1708 W Rogers Ave
Mt Washington, MD 21209
Phone (410) 578-5334
160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067
300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363
Interoperability endpoints
- cblaisdell135199@direct.hopkinsmedicine.org
Organizations & group practices 8
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.
-
dba St. Christopher's Pediatric Associates Emergency Medicine - E. Erie A
- Pediatric Emergency Medicine (Pediatrics) Physician
- Philadelphia, PA
- NPI 1144864547
-
dba Jhu - Anesthesia Pain MGMT
- Pain Medicine (Anesthesiology) Physician
- Baltimore, MD
- NPI 1922008549
-
dba St. Christopher's Pediatric Associates Ophthalmology - Newtown Yardley
- Ophthalmology Physician
- Newtown, PA
- NPI 1548141997
-
dba St. Christopher's Pediatric Associates Pulmonary - E. Erie Avenue
- Pediatric Pulmonology Physician
- Philadelphia, PA
- NPI 1881238251
-
dba Jhu -Pediatrics/Pulmonary
- Pediatric Pulmonology Physician
- Baltimore, MD
- NPI 1285621714
-
dba JHU - 4692 Millennium Drive - Physician
- Ophthalmology Physician
- Belcamp, MD
- NPI 1376342774
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- General Acute Care Hospital
- Baltimore, MD
- NPI 1578597993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1760437545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 62063",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212642063",
"telephone_number": "410-706-5181",
"fax_number": "410-706-5103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 E ERIE AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191341011",
"telephone_number": "215-427-5085"
}
],
"practiceLocations": [
{
"address_1": "22 S Greene St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212011544",
"country_code": "US",
"telephone_number": "410-706-5181",
"fax_number": "410-706-5103",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLAISDELL",
"first_name": "CAROL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-23",
"last_updated": "2023-11-06",
"certification_date": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "MD",
"license": "D4210",
"primary": false
},
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "PA",
"license": "MD482909",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "302691400",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.