NPIMap

Individual provider Active NPI

Blair Lee Ciccarelli, RPA-C

  • Physician Assistant
  • Amsterdam, NY
National Provider Identifier
1861825473
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
016862 Issued in NY
Practice address
427 Guy Park Ave
Amsterdam, NY 12010-1054
Phone
(518) 841-7237
NPI assigned
Aug 19, 2013
Last updated
Aug 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 016862 NY Primary

Addresses

Primary practice location

427 Guy Park Ave
Amsterdam, NY 12010-1054

Mailing address

427 Guy Park Ave
Amsterdam, NY 12010-1054
Phone (518) 841-7237

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131118001195 NY Practitioner - Physician Assistant 3577799782 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saratoga HospitalGroup PAC ID 6406740273, 353 clinicians
Medical Pain Management Services PLLCGroup PAC ID 5395701544, 15 clinicians

Practice addresses (Care Compare)

211 Church St
Saratoga Springs, NY 12866-1003
Phone (518) 583-8421

3040 Route 50
Saratoga Springs, NY 12866-3073
Phone (518) 580-2273

3044 Route 50
Saratoga Springs, NY 12866-3073
Phone (518) 886-5800

375 Bay Rd
Suite 103
Queensbury, NY 12804-3013
Phone (518) 682-2240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
68.51 of 100Reported as group
Quality
56.19
Improvement activities
40
Cost
75.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
016862NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince Apr 1, 2014 Accepting new patients
Medical Pain Management Services, PLLC Physician Assistant CurrentSince Nov 1, 2025 Accepting new patients
Saratoga Hospital CurrentSince Apr 1, 2014 Accepting new patients
New York Pain Management PLLC CurrentSince Nov 1, 2025 Accepting new patients
Saratoga Regional Medical , P.C CurrentSince Jun 1, 2018 Accepting new patients
Sand Creek Medical PC Past Accepting new patients

Locations

116 Everett Rd
Albany, NY 12205
Phone (518) 437-1200

112 Charlton Rd
Charlton, NY 12019
Phone (518) 399-7723

2911 State Route 9
Ste 1
Malta, NY 12020
Phone (518) 363-8815

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

375 Bay Rd
Ste 103
Queensbury, NY 12804
Phone (518) 371-0777

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

3 Care Ln
Saratoga Springs, NY 12866
Phone (518) 226-6000

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

Interoperability endpoints

  • Direct secure messaging: bciccarelli@ascpm.medentdirect.com
  • Direct secure messaging: bciccarelli97623@albanymed.direct-ci.com

Organizations & group practices 9

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1861825473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 GUY PARK AVE",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120101054",
            "telephone_number": "518-841-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 GUY PARK AVE",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120101054",
            "telephone_number": "518-841-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCARELLI",
        "first_name": "BLAIR",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

Verify at the official NPI Registry.