DR. SHANE ANTHONY BLACKMORE (NPI# 1669806055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669806055 |
| Entity Type | Individual |
| Full Name | DR. SHANE ANTHONY BLACKMORE |
| Credential | MD |
| Practice Address |
301 E 17th St Room 1402 New York NY 10003-3804 |
| Mailing Address |
2 Cooper Sq 9c New York NY 10003-7153 |
| Practice Telephone | 2125986509 |
| Practice Fax Number | 2125987654 |
| Mailing Telephone | 3474633405 |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2013-08-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
P89608 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
301 E 17TH ST ROOM 1402 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10003-3804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205830924 | Nadeige Genece | Pediatrics | 301 E 17th St, Suite 204, New York, NY 10003-3804 | 2005-06-09 |
| 1790307114 | Allison Schleichkorn | Physical Therapist | 301 E 17th St, New York, NY 10003-3804 | 2020-05-07 |
| 1407478993 | Sean Doyle | Physical Therapist | 301 E 17th St, New York, NY 10003-3804 | 2020-05-07 |
| 1871113902 | Niki Chan | Physical Therapist | 301 E 17th St, New York, NY 10003-3804 | 2020-04-18 |
| 1659900975 | Michael S Stern | Nurse Practitioner | 301 E 17th St, New York, NY 10003-3804 | 2020-04-07 |
| 1952937021 | Amy Belevan | Physical Therapist | 301 E 17th St, New York, NY 10003-3804 | 2020-03-20 |
| 1295384741 | Joellen Alves De Oliveira | Nurse Practitioner | 301 E 17th St, New York, NY 10003-3804 | 2019-09-07 |
| 1073169538 | Chelsea Brooke Schoen | Psychologist | 301 E 17th St, New York, NY 10003-3804 | 2019-08-12 |
| 1720634181 | Rebecca Kulzer | Psychologist | 301 E 17th St, New York, NY 10003-3804 | 2019-08-12 |
| 1588127203 | Nathan Jia | Student in an Organized Health Care Education/Training Program | 301 E 17th St, New York, NY 10003-3804 | 2019-04-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245841410 | Therapeutic Alliance of New York | Psychologist | Stephanie Zola, 1 Union Square South - Apt. 21d, New York, NY 10003 | 2020-08-12 |
| 1518586999 | Sandra Zajac | Student in an Organized Health Care Education/Training Program | 350 E17th St, 15 Baird Hall R15bh52, New York, NY 10003 | 2020-04-15 |
| 1235767260 | Katharine Krushel | Student in an Organized Health Care Education/Training Program | Mount Sinai Beth Israel, First Avenue At 16th Street, 7th Floor, Bernstein Pavilion Department of Psychiatry, New York, NY 10003 | 2020-03-27 |
| 1942836861 | Suzanne Redlich | Social Worker | 340 East 17th Street, Silver L.s53, New York, NY 10003 | 2020-03-23 |
| 1245864271 | Maureen Kreider | Nurse Practitioner | 4 Irving Place, Con Edison Employee Wellness Center, New York, NY 10003 | 2020-02-28 |
| 1235780321 | Stacy Hibbert | Social Worker | 337 East Street, New York, NY 10003 | 2019-09-20 |
| 1841846862 | Miryam Alkayyali | Student in an Organized Health Care Education/Training Program | Mount Sinai Beth Isreal, First Avenue and 16th Street, New York, NY 10003 | 2019-08-15 |
| 1215580600 | Anna Catherine Kasprzak | Physician Assistant | 9 Nathan D Perlman Place, Bernstein Building, New York, NY 10003 | 2019-07-24 |
| 1154973105 | Bob P Silverstein | Social Worker | 300 Mercer St., #11e, Bob P. Silverstein, Lcsw, New York, NY 10003 | 2019-07-10 |
| 1962064378 | Simon Garceau | Orthopaedic Surgery | 301 E 17th Street - Nyu Langone Orthopedic Hospital, Education Office, New York, NY 10003 | 2019-07-05 |
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| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609421122 | Mulchandani Medical Pllc | Orthopaedic Surgery | 139 Centre St Lbby Suite102, New York, NY 10013-4552 | 2019-08-02 |
| 1578046421 | Djf Orthopedics and Sports Medicine | Orthopaedic Surgery | 165 W End Ave Apt 28p, New York, NY 10023-5516 | 2018-09-06 |
| 1467872879 | Spencer Matthew Stein | Orthopaedic Surgery | 530 E 23rd St Apt 7f, New York, NY 10010-5030 | 2014-04-24 |
| 1235574435 | Stephanie Swensen Buza | Orthopaedic Surgery | 541 E 71st St, New York, NY 10021-4871 | 2013-05-02 |
| 1225271711 | J.l.glashow M.d.,p.c. | Orthopaedic Surgery | 737 Park Ave Ste 1c, New York, NY 10021-4256 | 2009-04-13 |
| 1255594230 | Alexis Chiang Colvin | Orthopaedic Surgery | 5 E. 98th St, Box 1188, New York, NY 10029 | 2008-07-09 |
| 1649354903 | Srino Bharam Md PC | Orthopaedic Surgery | 130 E. 77th St, 8 Fl Black Hall, New York, NY 10075 | 2006-10-24 |
| 1194816876 | Jerry Lubliner | Orthopaedic Surgery | 215 E 73rd St, Suite 3c, New York, NY 10021-3653 | 2006-09-27 |
| 1609834753 | Orrin Howard Sherman | Orthopaedic Surgery | 145 E. 32 Street, 4 Th Floor, New York, NY 10016-6055 | 2006-05-01 |
| 1275510182 | John Douglad Macgillivray | Orthopaedic Surgery | 523 E 72nd St, New York, NY 10021-4099 | 2005-12-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.