DR. SAMUEL CHARLES BLACKMAN (NPI# 1790782605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790782605 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL CHARLES BLACKMAN |
| Credential | MD, PHD |
| Practice Address |
34th & Civic Center Blvd Children's Hospital of Philadelphia Philadelphia PA 19104 |
| Mailing Address |
100 N 20th St Ste 301 Chca Philadelphia PA 19103-1454 |
| Practice Telephone | 2155901000 |
| Mailing Telephone | 2155672422 |
| Mailing Fax Number | 2159778864 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2008-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | MD433904 | PA | Allopathic & Osteopathic Physicians |
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
MD433904 | PA | Allopathic & Osteopathic Physicians |
| N | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
220358 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | AMERIHEALTH MERCY HEALTH PLAN --ONCOLOGY | 20074413 | 01 |
| PA | AMERIHEALTH MERCY HEALTH PLAN - GENERAL PEDIATRICS | 20074409 | 01 |
| PA | KEYSTONE MERCY HEALTH PLAN --GENERAL PEDIATRICS | 30052688 | 01 |
| KY | 64065881 | 05 | |
| PA | KEYSTONE MERCY HEALTH PLAN --ONCOLOGY | 30052689 | 01 |
| PA | CAQH ID | 11372260 | 01 |
| Street Address |
34TH & CIVIC CENTER BLVD CHILDREN'S HOSPITAL OF PHILADELPHIA |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528461233 | Ayesha Malik | Optometrist | 34th & Civic Center Blvd, Philadelphia, PA 19104-4306 | 2014-10-08 |
| 1891102281 | Lloyd Bender | Ophthalmology | 34th & Civic Center Blvd, Children's Hospital of Philadelphia, Philadelphia, PA 19104-4306 | 2014-07-17 |
| 1639414600 | Ignacio Juaneda Ruiz Funes | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 34th & Civic Center Blvd, Department of Ct Surgery, Philadelphia, PA 19104 | 2012-12-03 |
| 1306180641 | Bart P Leroy | Ophthalmology | 34th & Civic Center Blvd, Children's Hospital of Philadelphia, Philadelphia, PA 19104-4306 | 2012-11-26 |
| 1669727632 | Orith Waisbourd-zinman | Pediatrics | 34th & Civic Center Blvd, Philadelphia, PA 19104 | 2012-07-17 |
| 1396090361 | Anna Lee | Pathology | 34th & Civic Center Blvd, Philadelphia, PA 19104 | 2012-07-17 |
| 1528321882 | Adam Wolpaw | Pediatrics | 34th & Civic Center Blvd, 9nw55, Main Hospital, Philadelphia, PA 19104 | 2012-06-21 |
| 1356604615 | Ponney Palanisamy | Pediatrics | 34th & Civic Center Blvd, 9nw55, Main Hospital, Philadelphia, PA 19104 | 2012-06-21 |
| 1083977342 | Mary Vajravelu | Pediatrics | 34th & Civic Center Blvd, 9nw55, Main Hospital, Philadelphia, PA 19104 | 2012-06-21 |
| 1922361286 | Allison Barz | Pediatrics | 34th & Civic Center Blvd, 9nw55, Main Hospital, Philadelphia, PA 19104 | 2012-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356668503 | Sarah Ann Richman | Pediatrics | 3501 Civic Center Blvd, Ctrb 4020, Philadelphia, PA 19104-3820 | 2010-04-28 |
| 1063050680 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-12-13 |
| 1023656931 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-12-11 |
| 1083191852 | Caroline Jane Diorio | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2018-07-25 |
| 1699299917 | Amanda Li | Pediatrics | 3401 Civic Center Blvd, Division of Oncology, Philadelphia, PA 19104 | 2017-07-28 |
| 1194254557 | Haley Newman | Pediatrics | 3401 Civic Center Blvd, Division of Oncology, Philadelphia, PA 19104-4319 | 2017-06-08 |
| 1194266478 | Christina Turn | Pediatrics | 3401 Civic Center Blvd, Division of Hematology/oncology, Philadelphia, PA 19104 | 2017-03-20 |
| 1255786075 | Michelle Perry Milligan | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2016-04-29 |
| 1952765190 | Kailin Hsu | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2016-04-13 |
| 1225492945 | Aleksandra Sarah Dain | Pediatrics | 3401 Civic Center Blvd, Division of Pediatric Hematology/oncology, Philadelphia, PA 19104 | 2016-04-08 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on DR. SAMUEL CHARLES BLACKMAN.
| 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.