DR. EDWARD BLACKMAN (MD) – Anatomic Pathology & Clinical Pathology Physician, NPI 1215903455
Anatomic Pathology & Clinical Pathology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. EDWARD BLACKMAN (MD)
Christopher Costanzo MD, 2190, Lynn Road, Thousand Oaks, Ventura County, California, 91360, United States
STE 220
THOUSAND OAKS, CA 91360
Phone: (805) 495-8050
Fax: (805) 496-2160
Type: Mailing
215, West Janss Road, Thousand Oaks, Ventura County, California, 91360, United States
THOUSAND OAKS, CA 91360
Phone: (805) 373-8582
Fax: (805) 373-6865
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $7,719.
Total Amount is formed as General ($7,719) + Research ($0) + Ownership ($0) = $7,719.
Last reported payment date: 2023-09-20 • Largest payer in this snapshot: Agilent Technologies, Inc. ($7,719).
Total Amount
$7,719
General + Research + Ownership
Payments
2
Total payment records
General Amount
$7,719
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Agilent Technologies, Inc. | $7,719 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-03-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050316000623 | I | Pathology | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91360)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | CA | |
| P A T H O L O G Y | CA | |
| Pathology, Hematology | CA | |
| P A T H O L O G Y | CA | |
| P A T H O L O G Y | CA |
Reviews
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