Active NPI
Gary Blair
- Emergency Medicine Physician
- Everett, MA
National Provider Identifier
1962498378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 79479
- Practice address
- 103 Garland St
Everett, MA 02149-5066 - Phone
- (617) 665-1000
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 79479 | MA | Primary |
Addresses
Primary practice location
103 Garland St
Everett, MA 02149-5066
Mailing address
163 Gore St
Cambridge, MA 02141-1131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3128369 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79479 | MA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts Institute of Technology | Past | Accepting new patients | |
| Hallmark Health System Inc | Past | Accepting new patients | |
| Cambridge Public Health Commission | Past | Accepting new patients | |
| Melrose Wakefield Emergency Physicians, Inc. | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1932313228
-
- Internal Medicine Physician
- Medford, MA
- NPI 1275673667
-
- Multi-Specialty Clinic/Center
- Cambridge, MA
- NPI 1346308723
-
- Emergency Medicine Physician
- Melrose, MA
- NPI 1790730539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340582400000",
"number": "1962498378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 GORE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021411131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 GARLAND ST",
"city": "EVERETT",
"state": "MA",
"postal_code": "021495066",
"telephone_number": "617-665-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIR",
"first_name": "GARY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2012-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MA",
"license": "79479",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3128369",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Everett, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.