Individual provider Active NPI

Bruce Ian Blatt, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1073868105
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD034733E Issued in PA
Practice address
7131 Frankford Ave
Philadelphia, PA 19135-1008
Phone
(215) 332-4164
NPI assigned
Jul 15, 2012
Last updated
Jan 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD034733E PA Primary

Addresses

Primary practice location

7131 Frankford Ave
Philadelphia, PA 19135-1008

Mailing address

101 E Olney Ave
Ste 400
Philadelphia, PA 19120-2470
Phone (215) 456-1825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040120000578 PA Practitioner - Internal Medicine 9436050531 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Community Health Associates, Inc Internal Medicine CurrentSince Sep 28, 2016 Accepting new patients
Einstein Community Health Associates, Inc CurrentSince Sep 28, 2016 Accepting new patients

Locations

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

101 E Olney Ave
Ste C5
Philadelphia, PA 19120
Phone (215) 927-1937

Organizations & group practices 2

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": "1342310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1073868105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE",
            "address_2": "STE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202470",
            "telephone_number": "215-456-1825",
            "fax_number": "215-456-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7131 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191351008",
            "telephone_number": "215-332-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATT",
        "first_name": "BRUCE",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD034733E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.