David Samuel Kornblum, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

ME145179 Issued in FL

Practice address

300 Pinellas St # Ms 47
Clearwater, FL 33756-3804

Phone

(727) 462-7907

Fax

(727) 462-7904

NPI assigned

Jun 8, 2017

Last updated

Jan 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508817529

  Internal Medicine

  Medicare reassignment NPD
• Eastside Hospitalists Inc

  • Hospitalist Physician
  • Hollywood, FL
  • NPI 1285676957
  Medicare reassignment NPD
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1013160704
  NPD

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1144759424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PINELLAS ST # MS 47",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563804",
            "telephone_number": "727-462-7907",
            "fax_number": "727-462-7904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PINELLAS ST # MS 47",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563804",
            "telephone_number": "727-462-7907",
            "fax_number": "727-462-7904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Prudential Dr Ste 304",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078205",
            "country_code": "US",
            "telephone_number": "904-202-3860",
            "fax_number": "904-202-3846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNBLUM",
        "first_name": "DAVID",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP03958",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME145179",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME145179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Kolthammer
• Nancy Annette Konow, LDH
• Heather Kopecky
• Kenneth Edward Kopitzke
• Heidi Gale Korn
• Angela M. Korte, D.C.
• Kimberly Korthanke
• Dani Korya, M.D.
• Edward Dwight Kosakoski, D.M.D
• Carly Grace Kosciolek, AUD

• Hospitalist Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Hospitalist Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.