Active NPI
Blaire Muller
- Physician Assistant
- Port Jefferson Station, NY
National Provider Identifier
1902353311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 020067
- Practice address
- 1500 Route 112 Ste 101
Port Jefferson Station, NY 11776-8054 - Phone
- (631) 751-3000
- Fax
- (631) 509-6559
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 020067 | NY | Primary |
Addresses
Primary practice location
1500 Route 112 Ste 101
Port Jefferson Station, NY 11776-8054
Mailing address
5 Medical Dr
Port Jefferson Medical Park
Port Jefferson Station, NY 11776-1601
Phone (631) 678-8393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- State University of New York at Stony Brook, School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
365 E Main St
Patchogue, NY 11772-3145
Phone (631) 751-3000
48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020067 | NY | MD | Occupational Therapist |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Organizations & group practices 1
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.
-
- Specialist
- Port Jefferson Station, NY
- NPI 1396794574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550707200000",
"number": "1902353311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 MEDICAL DR",
"address_2": "PORT JEFFERSON MEDICAL PARK",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117761601",
"telephone_number": "631-678-8393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 ROUTE 112 STE 101",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117768054",
"telephone_number": "631-751-3000",
"fax_number": "631-509-6559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLER",
"first_name": "BLAIRE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-01",
"last_updated": "2019-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "020067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.