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TRAVIS J BLACKBURN DPM
NPI 1649965476
Podiatrist - Foot & Ankle Surgery in Brooklyn, NY

Active since April 07, 2023PECOS Enrolled
121 DEKALB AVE, BROOKLYN, NY 11201(718) 250-8000 Get Directions Write a Review

NPPES record last updated: August 24, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 24, 2026, Apr 7, 2023 (2 updates tracked since 2023).

About Travis J Blackburn Dpm NPPES

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

TRAVIS J BLACKBURN DPM (NPI 1649965476) is an individual foot & ankle surgery provider in Brooklyn, New York, licensed in New York (007549) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649965476
Entity TypeIndividualMale
Primary Taxonomy213ES0103X
Provider Legal NameTRAVIS J BLACKBURNCredential: DPM
Location Address121 DEKALB AVEBrooklyn, NY 11201-5425
Mailing Address121 Dekalb AveBrooklyn, NY 11201-5425
Phone(718) 250-8000
Sole ProprietorNo
Enumeration DateApril 7, 2023
Last NPPES UpdateAugust 24, 20262 updates tracked since enumeration
NPPES CertifiedAugust 24, 2026
✔ NPI 1649965476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in NY · 007549
121 DEKALB AVE, Brooklyn, NY 11201
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Travis J Blackburn Dpm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

EVANGELIA DAVANOS PHARMD, CNSC
Pharmacist (Nutrition Support)
121 DEKALB AVE, B231
BROOKLYN, NY 11201
Kings County (718) 250-8211
MR. KWONG LAU
Student in an Organized Health Care Education/Training Program
121 DEKALB AVE
BROOKLYN, NY 11201
Kings County (718) 250-8000
SAISREE KONDA M.D.
Student in an Organized Health Care Education/Training Program
121 DEKALB AVE
BROOKLYN, NY 11201
Kings County (718) 250-8000
DR. UZOMA N UKOMADU M.D.
Orthopaedic Surgery (Hand Surgery)
121 DEKALB AVE, ORTHOSUITE
BROOKLYN, NY 11201
Kings County (718) 250-7700
DR. MARIANA AVELAR FALCONE DE MELO
Student in an Organized Health Care Education/Training Program
121 DEKALB AVE, HOUSE STAFF ADMINISTRATION
BROOKLYN, NY 11201
Kings County (718) 250-6604
SIMONE CARDOSO PT,DPT
Physical Therapist
121 DEKALB AVE
BROOKLYN, NY 11201
Kings County (718) 250-8143
MARIE METILAINE ALEXANDRE NURSE PRACTITIONER
Nurse Practitioner (Family)
121 DEKALB AVE
BROOKLYN, NY 11201
Kings County (718) 250-8026
DR. JESSIE COLTER FULLMER MD
Student in an Organized Health Care Education/Training Program
121 DEKALB AVE
BROOKLYN, NY 11201
Kings County (718) 250-8000

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 Travis Blackburn's NPI number?

The NPI number for Travis Blackburn is 1649965476. It was assigned to this individual provider in the NPPES registry on April 7, 2023.

Where is Travis Blackburn located?

Travis Blackburn practices at 121 Dekalb Ave, Brooklyn, NY 11201. The listed phone number is (718) 250-8000.

What is Travis Blackburn's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Travis Blackburn enrolled in Medicare?

Yes. Travis Blackburn is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Travis Blackburn was last updated on August 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.