Individual provider Active NPI

David Rosenblum, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Wallingford, CT
National Provider Identifier
1184605412
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
031414 Issued in CT
Practice address
Gaylord Farms Rd.
Wallingford, CT 06492
Phone
(203) 284-2800
Fax
(203) 679-3598
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 031414 CT Primary

Addresses

Primary practice location

Gaylord Farms Rd.
Wallingford, CT 06492

Mailing address

PO Box 400
Gaylord Farms Rd.
Wallingford, CT 06492-7048
Phone (203) 284-2800

Other identifiers 1

IdentifierTypeStateIssuer
1314145MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20090817000518 CT Practitioner - Physical Medicine and Rehabilitation 3779637376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
State University of New York at Buffalo School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gaylord Hospital, Inc.Group PAC ID 1153224191, 39 clinicians

Practice addresses (Care Compare)

50 Gaylord Farm Rd
Wallingford, CT 06492-2828
Phone (203) 284-2800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.25 of 100Reported as group
Quality
63.07
Improvement activities
40
Cost
77.51

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gaylord Hospital, Inc. CurrentSince Jul 1, 1991 Accepting new patients
Saint Raphael Faculty Physicians Past Accepting new patients

Locations

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

50 Gaylord Farm Rd
Wallingford, CT 06492
Phone (203) 679-3553

Interoperability endpoints

  • Direct secure messaging: drosenblum8174@direct.ynhh.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184605412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "address_2": "GAYLORD FARMS RD.",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064927048",
            "telephone_number": "203-284-2800",
            "fax_number": "203-679-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GAYLORD FARMS RD.",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-284-2800",
            "fax_number": "203-679-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBLUM",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "031414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1314145",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.