Burt Ross Blackstone, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

OS006397E Issued in PA

Practice address

1201 Langhorne Newtown Road
St Mary Medical Center
Langhorne, PA 19047

Phone

(215) 710-5900

Fax

(215) 710-6973

NPI assigned

Apr 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Specialty

General SurgeryAlso: Critical Care (Intensivists)

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Health Mid-Atlantic Medical GroupGroup PAC ID 7416861885, 350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Hospital, Langhorne, PA, CCN 390258

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bblackstone2061172@direct.trinity-health.org

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.

• Trinity Health Mid-Atlantic Medical Group

  • Surgery Physician
  • Langhorne, PA
  • NPI 1972982361
  Medicare reassignment Care Compare group NPD
• Trinity Health Mid-Atlantic Medical Group

  • Obstetrics & Gynecology Physician
  • Langhorne, PA
  • NPI 1346605466
  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
  • NPI 1639039175
  NPD
• Aria Health Physician Services

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053181297
  NPD (past)
• Aria Health Physician Services

  • Surgery Physician
  • Langhorne, PA
  • NPI 1114981123
  NPD (past)
• St Mary Medical Center

  • General Acute Care Hospital
  • Langhorne, PA
  • NPI 1780686931
  NPD (past)
• Trinity Health Mid-Atlantic Medical Group

  • Trauma Surgery Physician
  • Langhorne, PA
  • NPI 1093771271
  NPD (past)

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

• St Mary Medical Center

  • General Acute Care Hospital
  • Langhorne, PA
  • NPI 1780686931
  Care Compare affiliation

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1851358246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNIVERSITY DR STE 300",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401873",
            "telephone_number": "215-710-5522",
            "fax_number": "215-710-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 LANGHORNE NEWTOWN ROAD",
            "address_2": "ST MARY MEDICAL CENTER",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "19047",
            "telephone_number": "215-710-5900",
            "fax_number": "215-710-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTONE",
        "first_name": "BURT",
        "middle_name": "ROSS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "OS006397E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011712810011",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bblackstone@providers.smpa.myhealthprovider.org",
            "affiliation": "N",
            "endpointDescription": "SMMC Direct E-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1201 Langhorne Newtown Road",
            "address_2": "St Mary Medical Center",
            "city": "Langhorne",
            "state": "PA",
            "country_code": "US",
            "postal_code": "19047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thomas Bick, LCSW
• Louis David Bierman, D.O.
• Kayla Billger, LCSW
• Kimberly Binney
• Amanda M Black, MS,CPRP, L.P.C.
• Rebecca Blank, DPT
• Darren Blase
• Russel Bleiler III, DMD
• Michael Bluestein
• Lauren Blum, PHARM D

• Surgery Physician in Langhorne, PA
• Providers in Langhorne, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.