Individual provider Active NPI

Christian Blais, PA

  • Medical Physician Assistant
  • Bronx, NY
National Provider Identifier
1912634866
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
600 E 233Rd St
Bronx, NY 10466-2604
Phone
(718) 920-9000
NPI assigned
Aug 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

600 E 233Rd St
Bronx, NY 10466-2604

Mailing address

20 W 87TH St Apt 2a
New York, NY 10024-3562
Phone (203) 731-4669

Other identifiers 1

IdentifierTypeStateIssuer
X0012658062MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221123001534 NY Practitioner - Physician Assistant 5991173916 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028876NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Oct 10, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Oct 10, 2022 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

600 E 233rd St
Bronx, NY 10466
Phone (718) 920-1640

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: cblais@montefioredirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1912634866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W 87TH ST APT 2A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243562",
            "telephone_number": "203-731-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662604",
            "telephone_number": "718-920-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIS",
        "first_name": "CHRISTIAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "X0012658062",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.