Individual provider Active NPI

Richard I Blum, M.D.

  • Cardiovascular Disease Physician
  • San Diego, CA
National Provider Identifier
1043310030
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G53758 Issued in CA
Practice address
550 Washington St Ste 641
San Diego, CA 92103-2229
Phone
(619) 296-3888
Fax
(619) 296-3898
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X G53758 CA
Cardiovascular Disease Physician 207RC0000X G53758 CA Primary

Addresses

Primary practice location

550 Washington St Ste 641
San Diego, CA 92103-2229

Mailing address

1868 Altamira PL
San Diego, CA 92103-1202
Phone (619) 890-8107

Other identifiers 1

IdentifierTypeStateIssuer
00G537580MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050824000851 CA Practitioner - Cardiovascular Disease (Cardiology) 3072544576 Reassigns benefits to 3 organizations
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G53758CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Apr 10, 2019 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Scripps Mercy Physicians Cardiology Medical Corporation Cardiovascular Disease CurrentSince Jun 1, 2005 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Apr 10, 2019 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Sep 27, 2010 Accepting new patients

Locations

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

4065 3rd Ave
Ste 101
San Diego, CA 92103
Phone (619) 296-3800

4094 4th Ave
San Diego, CA 92103
Phone (619) 515-2545

Interoperability endpoints

  • Direct secure messaging: rblum27406@scrippshlth.medalliesdirect.net

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1043310030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1868 ALTAMIRA PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031202",
            "telephone_number": "619-890-8107",
            "fax_number": "619-296-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST STE 641",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032229",
            "telephone_number": "619-296-3888",
            "fax_number": "619-296-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "RICHARD",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "G53758",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G53758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G537580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.