DR. JERRY GENE BLAIVAS M.D.
NPI 1124060330
Legal Medicine in New York, NY
NPI Status: Active since June 12, 2006
Contact Information
445 E 77TH ST
NEW YORK, NY
ZIP 10021
Phone: (212) 772-3900
Fax: (212) 772-1919
- Individual
- Male
- Legal Medicine
- PECOS Enrolled
- Opted-Out Medicare
About JERRY BLAIVAS
This page provides the complete NPI Profile along with additional information for Jerry Blaivas, a provider established in New York, New York with a medical specialization in Legal Medicine. The healthcare provider is registered in the NPI registry with number 1124060330 assigned on June 2006. The practitioner's primary taxonomy code is 173000000X with license number 144945 1 (NY). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1124060330
- Provider Name
- DR. JERRY GENE BLAIVAS M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 445 E 77TH ST NEW YORK, NY 10021
- Location Phone
- (212) 772-3900
- Location Fax
- (212) 772-1919
- Mailing Address
- 445 E 77TH ST NEW YORK, NY 10021
- Mailing Phone
- (212) 772-3900
- Mailing Fax
- (212) 772-1919
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-12-2006
- Last Update Date
- 07-08-2007
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jerry Blaivas opted out of Medicare effective on 04-01-2013 until 04-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Legal Medicine
- Taxonomy Code
- 173000000X
- Type
- Other Service Providers
- License No.
- 144945 1
- License State
- NY
- Taxonomy Description
- 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.
Medicare Participation & PECOS Enrollment Status
Jerry Blaivas is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2013
Opt-Out End Date: 04-01-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Medical/Surgical Supplies (DA000N)
Lubricant, individual sterile packet, each (HCPCS:A4332)
1 DME suppliers used 13 Medicare Claims 2144 Services Paid
Orthotic Devices
DME-Orthotic Devices (DF008N)
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)
4 DME suppliers used 26 Medicare Claims 5600 Services Paid
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124060330, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124060330, enumerated as an "individual" on June 12, 2006.
The provider is located at 445 E 77TH ST NEW YORK, NY 10021 and the phone number is (212) 772-3900.
Legal Medicine with taxonomy code 173000000X.
