Cm Blaine MD PLLC
NPI 1396514618ActiveOrganization· Dermatology· East Patchogue, NY
Dermatology in East Patchogue, New York, registered in NPPES in December 2023. The authorized official on file is Jiyon J. Kim, PA, Physician Assistant. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1396514618 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 28, 2023 |
| Last updated in NPPES | Dec 28, 2023 |
| Certified by provider | Dec 28, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|
Other Dermatology providers in East Patchogue
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