NPIMap

Organization Active NPI

South Bay Brain and Spine

  • Specialist
  • San Jose, CA
National Provider Identifier
1114272978
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SOUTH BAY BRAIN AND SPINE
Practice address
2577 Samaritan Dr
Suite 710
San Jose, CA 95124-4100
Phone
(408) 358-0133
Fax
(408) 358-8134
NPI assigned
Jul 18, 2012
Last updated
Jul 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Authorized official

Name
Dr. Kenneth S. BlumenfeldNPI 1235158254
Title
M.D.
Phone
(408) 358-0133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X CA Primary

Addresses

Primary practice location

2577 Samaritan Dr
Suite 710
San Jose, CA 95124-4100

Mailing address

2577 Samaritan Dr
Suite 710
San Jose, CA 95124-4100
Phone (408) 358-0133

National Provider Directory

National Provider Directory
Tax ID family
South Bay Brain and Spine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1114272978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 SAMARITAN DR",
            "address_2": "SUITE 710",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244100",
            "telephone_number": "408-358-0133",
            "fax_number": "408-358-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 SAMARITAN DR",
            "address_2": "SUITE 710",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244100",
            "telephone_number": "408-358-0133",
            "fax_number": "408-358-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY BRAIN AND SPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "BLUMENFELD",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "408-358-0133",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.