BLUE NILE MEDICAL PLLC
NPI 1003322108
Internal Medicine in Brooklyn, NY

Q: What is Blue Nile Medical PLLC's NPI number?

The NPI number for Blue Nile Medical PLLC is 1003322108. It was assigned to this organization in the NPPES registry on December 27, 2017.

Q: What is Blue Nile Medical PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since December 27, 2017CLIA 33D1020714 · Waiver

9408 FLATLANDS AVE, BROOKLYN, NY 11236(718) 272-0977(718) 272-1088 Get Directions Write a Review

NPPES record last updated: December 27, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Blue Nile Medical Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE NILE MEDICAL PLLC (NPI 1003322108) is a healthcare organization registered as an internal medicine in Brooklyn, New York and active in the NPI registry since December 2017. The organization holds a CLIA Waiver certificate valid through September 29, 2028 and lists Sebhatu Gebrezgi, Owner, as its authorized official.

NPPES Registry Identity

NPI1003322108

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameBLUE NILE MEDICAL PLLC

Location Address9408 FLATLANDS AVEBrooklyn, NY 11236-3742

Mailing Address9408 Flatlands AveBrooklyn, NY 11236-3742 · (718) 272-0977 · Fax (718) 272-1088

Phone(718) 272-0977

Fax(718) 272-1088

Organization SubpartNo

Authorized OfficialSebhatu GebrezgiOwner · (718) 272-0977

Enumeration DateDecember 27, 2017

✔ NPI 1003322108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedLegal MedicineTaxonomy 173000000X

9408 FLATLANDS AVE, Brooklyn, NY 11236

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blue Nile Medical Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Blue Nile Medical PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Sebhatu Gebrezgi, MD

Internal Medicine

NPI 1982750360

9408 FLATLANDS AVE
Brooklyn, NY 11236

(718) 272-0977

✔ PECOS✔ Accepts MedicareSame address

Berhane Wubshet, M.D.

Internal Medicine

NPI 1013963297

9131 175TH ST
Jamaica, NY 11432

(718) 657-6363

✔ PECOS✔ Accepts Medicare7.7 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1020714

Blue Nile Medical PLLC · Brooklyn, NY

Active · expires Sep 29, 2028

CLIA Number33D1020714

Laboratory TypePhysician Office

Certificate Effective DateSeptember 30, 2026

Certificate Expiration DateSeptember 29, 2028

Laboratory DirectorDr. Sebhatu T. Gebrezgi

Laboratory Phone(718) 272-0977

Laboratory LocationBlue Nile Medical PLLC9408 Flatlands Avenue, Brooklyn, NY 11236

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blue Nile Medical PLLC's NPI number?

The NPI number for Blue Nile Medical PLLC is 1003322108. It was assigned to this organization in the NPPES registry on December 27, 2017.

Where is Blue Nile Medical PLLC located?

Blue Nile Medical PLLC is located at 9408 Flatlands Ave, Brooklyn, NY 11236. The listed phone number is (718) 272-0977.

What is Blue Nile Medical PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Blue Nile Medical PLLC enrolled in Medicare?

Yes. Blue Nile Medical PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Blue Nile Medical PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Blue Nile Medical PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Blue Nile Medical PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1020714) is associated with this NPI, valid through September 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Blue Nile Medical PLLC was last updated on December 27, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.