ELIZABETH MARIE BLAIR (PSYD) – Psychologist, NPI 1730107228

ELIZABETH MARIE BLAIR (PSYD) is a healthcare provider. based in Glendale, Wisconsin. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. 2121057 (WI). The NPI Number for ELIZABETH MARIE BLAIR (PSYD) is 1730107228

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
ELIZABETH MARIE BLAIR (PSYD)
NPI
1730107228
Phone
(414) 962-4048
Address
5900 N PORT WASHINGTON RD
Enumeration Date
17 July 2006
Last Update Date
3 November 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4142243737
Graduation Year
1997 (29 years ago)
PAC ID
4981658218
Group Practice PAC ID
5092740985
Professional Enrollment ID
I20050309000417
Address ID
WI532024212MI229XXAVEX402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

667 CLINICAL PSYCHOLOGIST in WI

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Provider Addresses for ELIZABETH MARIE BLAIR (PSYD)

  • 5900, North Port Washington Road, Glendale, Milwaukee County, Wisconsin, 53217, United States

    STE 230

    GLENDALE, WI 53217

    Phone: (414) 962-4048

    Fax: (414) 962-4052

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2005-03-09

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050309000417IClinical PsychologistWITBD

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.

Verify on CMS Revalidation Lookup Tool

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 53217)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092740985View full group profile
NameSpecialtyState
P S Y C H I A T R YWI
Clinical PsychologistWI
Clinical Social WorkerWI
Clinical Social WorkerWI
Nurse PractitionerME
Clinical Social WorkerWI
Clinical Social WorkerWI
Clinical Social WorkerWI
Clinical Social WorkerWI
Clinical Social WorkerWI

Reviews

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Frequently asked questions

Does ELIZABETH MARIE BLAIR (PSYD) have a public NPI I can cite?
Public records show ELIZABETH MARIE BLAIR (PSYD) under NPI 1730107228.
Quick check: is ELIZABETH MARIE BLAIR (PSYD) active?
Public NPPES data shows ELIZABETH MARIE BLAIR (PSYD) with an active NPI status right now.
What type of care does ELIZABETH MARIE BLAIR (PSYD) provide?
ELIZABETH MARIE BLAIR (PSYD)'s profile centers on Psychologist. Clinical services aligned with this taxonomy classification.
What city is tied to ELIZABETH MARIE BLAIR (PSYD)?
The directory associates ELIZABETH MARIE BLAIR (PSYD) with Glendale, Wisconsin. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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