Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. JERRY GENE BLAIVAS M.D.
NPI 1124060330
Legal Medicine in New York, NY

Q: What is Jerry Blaivas's NPI number?

The NPI number for Jerry Blaivas is 1124060330. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Q: What is Jerry Blaivas's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Q: Is Jerry Blaivas enrolled in Medicare?

No. Jerry Blaivas has opted out of Medicare through April 1, 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.

Q: When was this NPI record last updated?

The NPPES record for Jerry Blaivas was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 days 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.

Active since June 12, 2006Opted out of Medicare · through Apr 1, 2027

445 E 77TH ST, NEW YORK, NY 10021(212) 772-3900(212) 772-1919 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Jerry Gene Blaivas M.d. NPPES

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

DR. JERRY GENE BLAIVAS M.D. (NPI 1124060330) is an individual legal medicine provider in New York, New York, licensed in New York (144945 1) and active in the NPI registry since June 2006. He has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1124060330

Entity TypeIndividualMale

Primary Taxonomy173000000X

Provider Legal NameDR. JERRY GENE BLAIVASCredential: M.D.

Location Address445 E 77TH STNew York, NY 10021-2318

Mailing Address445 E 77th StNew York, NY 10021-2318 · (212) 772-3900 · Fax (212) 772-1919

Phone(212) 772-3900

Fax(212) 772-1919

Sole ProprietorNo

Enumeration DateJune 12, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1124060330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLegal MedicineOther Service Providers

Taxonomy Code173000000X

License✔ Licensed in NY · 144945 1

Definition

The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.

445 E 77TH ST, New York, NY 10021

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jerry Gene Blaivas M.d. 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 April 1, 2013 through April 1, 2027.

Opt-Out Effective DateApril 1, 2013

Opt-Out In Effect ThroughApril 1, 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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lubricant, individual sterile packet, each A4332

DME-Medical/Surgical Supplies · category DA000N

1 supplier13 claims2,144 services$0.10 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

4 suppliers26 claims5,600 services$1.51 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

MR. ALLAN WHITEMAN LCSW

Social Worker (Clinical)

445 E 77TH ST, #5N
NEW YORK, NY 10021

New York County (212) 737-1680

DR. RAJVEER PUROHIT M.D.

Urology

445 E 77TH ST
NEW YORK, NY 10021

New York County (212) 772-3900

JERRY G BLAIVAS MD

Urology

445 E 77TH ST
NEW YORK, NY 10021

New York County (212) 772-3900

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 Jerry Blaivas's NPI number?

The NPI number for Jerry Blaivas is 1124060330. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Where is Jerry Blaivas located?

Jerry Blaivas practices at 445 E 77th St, New York, NY 10021. The listed phone number is (212) 772-3900.

What is Jerry Blaivas's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Is Jerry Blaivas enrolled in Medicare?

No. Jerry Blaivas has opted out of Medicare through April 1, 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 Jerry Blaivas was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 days 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.