DR. THEODORE BLAINE MD
NPI 1376576421
Orthopaedic Surgery - Sports Medicine in New York, NY

Active since July 09, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
535 E 70TH ST, NEW YORK, NY 10021(203) 705-0766(860) 247-3803 Get Directions Write a Review

NPPES record last updated: December 21, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 21, 2020, Dec 17, 2020, Nov 1, 2017 (3 updates tracked since 2017).

About Dr. Theodore Blaine Md NPPES

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

DR. THEODORE BLAINE MD (NPI 1376576421) is an individual sports medicine provider in New York, New York, licensed in Connecticut (039067) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Hospital For Special Surgery, and is a graduate of University Of Connecticut School Of Medicine (1993).

NPPES Registry Identity

NPI1376576421
Entity TypeIndividualMale
Primary Taxonomy207XX0005X
Provider Legal NameDR. THEODORE BLAINECredential: MD
Location Address535 E 70TH STNew York, NY 10021-4823
Mailing AddressPo Box 29234New York, NY 10087-9234 · (203) 705-0766
Fax(860) 247-3803
Sole ProprietorNo
Medical School CMSUniversity Of Connecticut School Of MedicineGraduated 1993
Enumeration DateJuly 9, 2006
Last NPPES UpdateDecember 21, 20203 updates tracked since enumeration
NPPES CertifiedDecember 21, 2020
NPI 1376576421 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License Licensed in CT · 039067
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License 12523 (RI), 196273-1 (NY), 39067 (CT)
535 E 70TH ST, New York, NY 10021

Other Identifiers 1

Other200001063CT · Ct Medicare Number

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Theodore Blaine Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143286237
PECOS Enrollment IDI20041209000952, I20190903003076
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
339 services226 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
231 services50 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
88 services88 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
76 services62 patients
Anchoring of biceps tendon 23430
Anchoring of the biceps tendon is a surgical procedure aimed at restoring stability to your arm. The surgeon secures your biceps tendon to the bone using special anchors, which helps to reduce pain and improve arm function.
49 services48 patients
Prosthetic repair of shoulder joint, total shoulder 23472
Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.
49 services48 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hospital For Special Surgery

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330270
Location535 East 70th StreetNew York, NY 10021 · New York County
Emergency services

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims

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

Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf L3670
DME-Orthotic Devices · category DF000N
2 suppliers58 claims58 services$92.17 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 20

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

Physician Assistant (Surgical)
535 E 70TH ST
NEW YORK, NY 10021
Anesthesiology
535 E 70TH ST
NEW YORK, NY 10021
Specialist/Technologist (Athletic Trainer)
535 E 70TH ST
NEW YORK, NY 10021
Speech-Language Pathologist
535 E 70TH ST
NEW YORK, NY 10021
Anesthesiology
535 E 70TH ST
NEW YORK, NY 10021
Physical Therapist
535 E 70TH ST
NEW YORK, NY 10021
Orthopaedic Surgery (Pediatric Orthopaedic Surgery)
535 E 70TH ST
NEW YORK, NY 10021
Physician Assistant
535 E 70TH ST
NEW YORK, NY 10021

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 Theodore Blaine's NPI number?

The NPI number for Theodore Blaine is 1376576421. It was assigned to this individual provider in the NPPES registry on July 9, 2006.

Where is Theodore Blaine located?

Theodore Blaine practices at 535 E 70th St, New York, NY 10021. The listed phone number is (203) 705-0766.

What is Theodore Blaine's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Theodore Blaine enrolled in Medicare?

Yes. Theodore Blaine is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Theodore Blaine affiliated with any hospitals?

According to CMS data, Theodore Blaine is affiliated with Hospital For Special Surgery.

When was this NPI record last updated?

The NPPES record for Theodore Blaine was last updated on December 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.