Individual provider Active NPI

Marc S Goldblatt, M.D.

  • Colon & Rectal Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1154317824
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
10188 Issued in AZ
Practice address
1331 N 7TH St Ste 275
Phoenix, AZ 85006-2769
Phone
(602) 252-7004
Fax
(602) 252-6232
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 10188 AZ Primary

Addresses

Primary practice location

1331 N 7TH St Ste 275
Phoenix, AZ 85006-2769

Mailing address

1331 N 7TH St Ste 275
Phoenix, AZ 85006-2769
Phone (602) 252-7004

Other identifiers 1

IdentifierTypeStateIssuer
205410MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20101015000042 AZ Practitioner - Colorectal Surgery (Proctology) 4880621853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
State University of New York Downstate Medical Center, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliated Colon and Rectal Surgeons PCGroup PAC ID 1456345339, 2 clinicians

Practice addresses (Care Compare)

1331 N 7TH St
Suite 275
Phoenix, AZ 85006-2769
Phone (602) 252-7004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10188AZMDPhysical Therapist

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHJDCA/Endpoint/GHJDCA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1154317824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 N 7TH ST STE 275",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062769",
            "telephone_number": "602-252-7004",
            "fax_number": "602-252-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 N 7TH ST STE 275",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062769",
            "telephone_number": "602-252-7004",
            "fax_number": "602-252-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBLATT",
        "first_name": "MARC",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "AZ",
            "license": "10188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205410",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.