Miriam S Blau, R.N., P.N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

381940 Issued in NY

Practice address

7 Ismay St
Staten Island, NY 10314-5019

Phone

(917) 744-1740

Fax

(718) 815-8122

NPI assigned

Jul 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: miriam.blau.p1@direct.ezramedical.nextgenshare.com

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.

• Miriam Gordon Pediatric NP PC

  • Pediatric Nurse Practitioner
  • Staten Island, NY
  • NPI 1750845137

  Pediatrics

  NPD (past) Authorized official

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1780884205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ISMAY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145019",
            "telephone_number": "917-744-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ISMAY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145019",
            "telephone_number": "917-744-1740",
            "fax_number": "718-815-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAU",
        "first_name": "MIRIAM",
        "middle_name": "S",
        "credential": "R.N., P.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "520046-1",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "381940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02460364",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Andrew Blasco, M.D.
• Lorraine Susan Blasi Plaut, MSED
• Marrianne Blasso, PT
• Ilona Blaton, MPT
• Jonathan A Blau, M.D.
• Lauren Blazewicz
• Blessed Hands Rehab PT PC
• Juri Blinder, RN
• Beth Blitzstein, MA OTR/L
• Valbona Bllata

• Pediatric Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.