NPIMap

Individual provider Active NPI

Eric Pollack Blazar, MD

  • Emergency Medicine Physician
  • Vineland, NJ
National Provider Identifier
1861758211
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA09656300 Issued in NJ
Practice address
1505 W Sherman Ave
Vineland, NJ 08360-7059
Phone
(856) 686-4319
NPI assigned
Apr 10, 2012
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA09656300 NJ Primary

Addresses

Primary practice location

1505 W Sherman Ave
Vineland, NJ 08360-7059

Mailing address

1505 W Sherman Ave
Vineland, NJ 08360-7059
Phone (937) 470-1882

Other identifiers 1

IdentifierTypeStateIssuer
0471925MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150731015314 NJ Practitioner - Emergency Medicine 3870726813 Reassigns benefits to 4 organizations
I20160801000030 PA Practitioner - Emergency Medicine 3870726813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Northeastern Ohio University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Jersey Hyperbaric Medicine LLCGroup PAC ID 9436427499, 28 clinicians

Practice addresses (Care Compare)

501 Front St
Elmer, NJ 08318-2101
Phone (856) 363-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA09656300NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of South Jersey P C Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince May 31, 2016 Accepting new patients
South Jersey Health System Emergency Physician Services P a Emergency Medicine CurrentSince Jun 20, 2015 Accepting new patients
South Jersey Hyperbaric Medicine LLC CurrentSince Apr 26, 2017 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince May 31, 2016 Accepting new patients
Emergency Physician Services of New Jersey,Professional Association Emergency Medicine CurrentSince Nov 1, 2018 Accepting new patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients

Locations

100 Townsend Ave
Berlin, NJ 08009
Phone (856) 322-3000

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

18 W Laurel Rd
Stratford, NJ 08084
Phone (856) 345-7816

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1861758211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607059",
            "telephone_number": "937-470-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607059",
            "telephone_number": "856-686-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZAR",
        "first_name": "ERIC",
        "middle_name": "POLLACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA09656300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0471925",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.