OrganizationActive
Ambulatory Medical Services
NPI 1609811496 · Anesthesiology Physician · Massapequa, NY
Provider details
- NPI number
- 1609811496
- Entity type
- Organization
- Primary specialty
- Anesthesiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mordecai Bluth, Director(718) 815-1000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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 methodology.
Practice location
187 Veterans Blvd
Massapequa, NY 11758-4982
Phone: (718) 815-1000
Fax: (718) 815-8122
Approximate (ZIP-level) locationGet directions
Mailing address
302 Manor Rd
Staten Island, NY 10314-2408
Registry dates
- Enumerated
- 2006-06-17
- Last updated
- 2008-07-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.