SUSAN G BLANK, MD, LLC
NPI 1164617668
Psychiatry & Neurology - Psychiatry in Clark, NJ
About Susan G Blank, Md, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUSAN G BLANK, MD, LLC (NPI 1164617668) is a healthcare organization registered as a psychiatry in Clark, New Jersey and active in the NPI registry since September 2007. The organization lists Susan G Blank, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Susan G Blank, Md, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Susan G Blank, MD, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Susan G Blank, MD, LLC's NPI number?
The NPI number for Susan G Blank, MD, LLC is 1164617668. It was assigned to this organization in the NPPES registry on September 8, 2007.
Where is Susan G Blank, MD, LLC located?
Susan G Blank, MD, LLC is located at 45 Brant Ave Suite 2, Clark, NJ 07066. The listed phone number is (732) 340-0300.
What is Susan G Blank, MD, LLC's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.
Is Susan G Blank, MD, LLC enrolled in Medicare?
Yes. Susan G Blank, MD, LLC is registered in the Medicare PECOS enrollment system.
When is Susan G Blank, MD, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Jersey, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Susan G Blank, MD, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Psychiatry) reassigns their Medicare billing to Susan G Blank, MD, LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Susan G Blank, MD, LLC was last updated on September 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.
# Susan G Blank, Md, Llc · NPI 1164617668
Psychiatry organization in Clark, New Jersey. Organization record, active in the CMS NPPES registry since September 8, 2007.
## Identity
- **NPI:** 1164617668 (Entity type: Organization)
- **Enumerated:** September 8, 2007
- **Primary specialty:** Psychiatry & Neurology - Psychiatry · taxonomy 2084P0800X
- **Organization subpart:** No
- **Authorized official:** Susan Blank, OWNER
## Practice location
- **Address:** 45 BRANT AVE, SUITE 2, Clark, NJ 07066-1562
- **Phone:** (732) 340-0300 · **Fax:** (732) 340-9300
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, New Jersey, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Psychiatry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 8, 2007
- **Other identifiers:** Medicare UPIN G63514 (NJ); Medicare PIN 098725 (NJ)
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Source: [NPI Profile](https://npiprofile.com/npi/1164617668) · Data from the CMS NPPES public registry.