Individual provider Active NPI

Gideon Blumstein, MD, MS

  • Orthopaedic Surgery of the Spine Physician
  • Marina del Rey, CA
National Provider Identifier
1164819207
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
A149225 Issued in CA
Practice address
4640 Admiralty Way Ste 600
Marina del Rey, CA 90292-6638
Phone
(310) 448-7890
NPI assigned
Apr 15, 2015
Last updated
Dec 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 036.155746 IL
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery of the Spine Physician 207XS0117X A149225 CA Primary

Addresses

Primary practice location

4640 Admiralty Way Ste 600
Marina del Rey, CA 90292-6638

Mailing address

10833 Le Conte Ave RM 76-143
Los Angeles, CA 90095-3075
Phone (310) 825-6557

Other practice location 1

10833 Le Conte Ave Rm 76-143
Los Angeles, CA 90095-3075
Phone (310) 825-6557

Other practice location 2

1611 W Harrison St Ste 201
Chicago, IL 60612-4861
Phone (312) 563-6306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20221110001221 CA Practitioner - Orthopedic Surgery 3971855362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Southern California Keck School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

4640 Admiralty Way
Suite 600
Marina del Rey, CA 90292-6638
Phone (310) 448-7840

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion85
Laminectomy or laminotomy (partial removal of spine bones)81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A149225CAMDOrthopaedic Surgery of the Spine Physician
036.155746ILMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Nov 1, 2022 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4640 Admiralty Way
Ste 600
Marina del Rey, CA 90292
Phone (310) 448-7840

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: gblumstein435136@direct.cshs.org

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1164819207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE RM 76-143",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-825-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY STE 600",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926638",
            "telephone_number": "310-448-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10833 Le Conte Ave Rm 76-143",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900953075",
            "country_code": "US",
            "telephone_number": "310-825-6557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1611 W Harrison St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124861",
            "country_code": "US",
            "telephone_number": "312-563-6306",
            "fax_number": "312-942-2040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUMSTEIN",
        "first_name": "GIDEON",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "IL",
            "license": "036.155746",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A149225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.