Individual provider Active NPI

Rachel Lynne Appelblatt, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • South Lake Tahoe, CA
National Provider Identifier
1033353511
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
64526 Issued in CA
Practice address
591 Tahoe Keys Blvd
Suite D4
South Lake Tahoe, CA 96150-3358
Phone
(530) 541-4042
NPI assigned
Apr 28, 2009
Last updated
Sep 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 64526 CA Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 136733 CA

Addresses

Primary practice location

591 Tahoe Keys Blvd
Suite D4
South Lake Tahoe, CA 96150-3358

Mailing address

591 Tahoe Keys Blvd
Suite D4
South Lake Tahoe, CA 96150-3358
Phone (530) 541-4042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Aug 12, 2015 through Aug 12, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
136733CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Oral Surgery Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1033353511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 TAHOE KEYS BLVD",
            "address_2": "SUITE D4",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503358",
            "telephone_number": "530-541-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 TAHOE KEYS BLVD",
            "address_2": "SUITE D4",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503358",
            "telephone_number": "530-541-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APPELBLATT",
        "first_name": "RACHEL",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "64526",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "136733",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

Verify at the official NPI Registry.