Individual provider Active NPI

Jerome Ira Block, M.D.

  • Anesthesiology Physician
  • Monte Sereno, CA
National Provider Identifier
1164690905
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G25106 Issued in CA
Practice address
15344 Karl Ave
Monte Sereno, CA 95030-2230
Phone
(408) 395-5809
NPI assigned
Feb 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G25106 CA Primary

Addresses

Primary practice location

15344 Karl Ave
Monte Sereno, CA 95030-2230

Mailing address

15344 Karl Ave
Monte Sereno, CA 95030-2230
Phone (408) 395-5809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G25106CAMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1164690905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15344 KARL AVE",
            "city": "MONTE SERENO",
            "state": "CA",
            "postal_code": "950302230",
            "telephone_number": "408-395-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15344 KARL AVE",
            "city": "MONTE SERENO",
            "state": "CA",
            "postal_code": "950302230",
            "telephone_number": "408-395-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "JEROME",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G25106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monte Sereno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.