Theodore Blaine, MD
NPI 1376576421 · Sports Medicine (Orthopaedic Surgery) Physician · New York, NY
Enrolled with Medicare as Practitioner - Orthopedic Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Theodore Blaine, MD is a Sports Medicine (Orthopaedic Surgery) Physician provider in New York, NY (NPI 1376576421).
Provider details
- NPI number
- 1376576421
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 12523 (RI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
19 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
620 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 339 | $133 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 88 | $174 |
| Aspiration And/Or Injection of Fluid From Large Joint20610 | 76 | $75 |
| Anchoring of Biceps Tendon23430 | 49 | $395 |
| Prosthetic Repair of Shoulder Joint, Total Shoulder23472 | 49 | $1,511 |
| New Patient Office Or Other Outpatient Visit With Low Level of Medical Decision Making, If Using Time, 30 Minutes Or More99203 |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$201,796 across 25 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-07-09
- Last updated
- 2020-12-21
- Certified
- 2020-12-21
Frequently asked questions
- What is Theodore Blaine's NPI number?
- Theodore Blaine's National Provider Identifier (NPI) is 1376576421, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Theodore Blaine's specialty?
- Theodore Blaine is listed in the NPPES registry with a primary specialty of Sports Medicine (Orthopaedic Surgery) Physician (Allopathic & Osteopathic Physicians).
- Where is Theodore Blaine located?
- Theodore Blaine's practice location on file with NPPES is 535 E 70th St, New York, NY 10021-4823.
- What is Theodore Blaine's phone number?
- The practice phone number listed in the NPPES registry for Theodore Blaine is (203) 705-0766.
- Does Theodore Blaine accept Medicare?
- Theodore Blaine is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Theodore Blaine's NPI active?
- Yes — Theodore Blaine's NPI (1376576421) is active in the NPPES registry as of the last update on 2020-12-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.