Active NPI
Bennett Blumenkopf, MD
- Neurological Surgery Physician
- Pittsburgh, PA
National Provider Identifier
1184624850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- MD426898
- Practice address
- 420 E North Ave
Suite 302 Agh Neurosurgery
Pittsburgh, PA 15212-4746 - Phone
- (412) 359-6200
- Fax
- (412) 359-6617
- NPI assigned
- Jul 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | MD426898 | PA | Primary |
Addresses
Primary practice location
420 E North Ave
Suite 302 Agh Neurosurgery
Pittsburgh, PA 15212-4746
Mailing address
420 E North Ave
Suite 302 Agh Neurosurgery
Pittsburgh, PA 15212-4746
Phone (412) 359-6200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810006248 | Medicaid | WV | |
| 2586803 | Medicaid | OH | |
| 0010437730002 | Medicaid | PA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD426898 | PA | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Group Inc | Past | Accepting new patients |
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.
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- Worcester, MA
- NPI 1760445373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207785600000",
"number": "1184624850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 E NORTH AVE",
"address_2": "SUITE 302 AGH NEUROSURGERY",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152124746",
"telephone_number": "412-359-6200",
"fax_number": "412-359-6617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 E NORTH AVE",
"address_2": "SUITE 302 AGH NEUROSURGERY",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152124746",
"telephone_number": "412-359-6200",
"fax_number": "412-359-6617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUMENKOPF",
"first_name": "BENNETT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-26",
"last_updated": "2008-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "PA",
"license": "MD426898",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810006248",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2586803",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0010437730002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.