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ELLEN BLANK MD
NPI 1033282900
Dermatology in Staten Island, NY

Active since November 16, 2006Opted out of Medicare · through Jul 30, 2027
1122 RICHMOND ROAD, STATEN ISLAND, NY 10304(718) 987-3300(718) 987-3451 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ellen Blank Md NPPES

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

ELLEN BLANK MD (NPI 1033282900) is an individual dermatology provider in Staten Island, New York, licensed in New York (25MA03293600) and active in the NPI registry since November 2006. She has opted out of Medicare through July 30, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1033282900
Entity TypeIndividualFemale
Primary Taxonomy207N00000X
Provider Legal NameELLEN BLANKCredential: MD
Location Address1122 RICHMOND ROADStaten Island, NY 10304
Mailing Address333 Avenue CBayonne, NJ 07002 · (201) 858-4800 · Fax (201) 858-3005
Phone(718) 987-3300
Fax(718) 987-3451
Sole ProprietorNo
Enumeration DateNovember 16, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1033282900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in NY · 25MA03293600
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1122 RICHMOND ROAD, Staten Island, NY 10304
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Ellen Blank Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 30, 2015 through July 30, 2027.

Opt-Out Effective DateJuly 30, 2015
Opt-Out In Effect ThroughJuly 30, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MITCHELL ALFRED SCHUMAN MD
Ophthalmology
1122 RICHMOND ROAD
STATEN ISLAND, NY 10304
Richmond County (718) 987-3300

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 Ellen Blank's NPI number?

The NPI number for Ellen Blank is 1033282900. It was assigned to this individual provider in the NPPES registry on November 16, 2006.

Where is Ellen Blank located?

Ellen Blank practices at 1122 Richmond Road, Staten Island, NY 10304. The listed phone number is (718) 987-3300.

What is Ellen Blank's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Ellen Blank enrolled in Medicare?

No. Ellen Blank has opted out of Medicare through July 30, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Ellen Blank was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.