Lisa Rose Blum

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

043633 Issued in NY

Practice address

99 University PL
FL 9
New York, NY 10003-4528

Phone

(212) 604-1316

Fax

(212) 604-1320

NPI assigned

Oct 10, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lisa Blum Physical Therapy PLLCGroup PAC ID 4981007549, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lisa Blum Physical Therapy PLLC

  • Physical Therapist
  • New York, NY
  • NPI 1346823069
  Medicare reassignment Care Compare group NPD Authorized official
• Shift Physical Therapy, PLLC

  • Physical Therapist
  • New York, NY
  • NPI 1588776512
  Medicare reassignment NPD

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1891260402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 UNIVERSITY PL",
            "address_2": "FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034528",
            "telephone_number": "212-604-1316",
            "fax_number": "212-604-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 UNIVERSITY PL",
            "address_2": "FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034528",
            "telephone_number": "212-604-1316",
            "fax_number": "212-604-1320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Northern Blvd Ste 11",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110214802",
            "country_code": "US",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUM",
        "first_name": "LISA",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordie Blum
• Joshua Nathan Blum, MSED, LMHC
• Julia Ann Blum
• Lawrence Roy Blum, MD
• Leslie Frances Blum, MD
• Michele Keren Blum, LMSW
• Raia Antonia Blum, MD
• Robin R Blum, M.D.
• Ronald Blum, MD
• Rye Dario Pianko Blum, ANP, WHNP

• Physical Therapist in New York, NY
• Providers in New York, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.