Norman I Kornblatt, D.P.M

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

553 Issued in GA

Practice address

3666 Highway 5
Ste 101
Douglasville, GA 30135-6940

Phone

(770) 942-3668

Fax

(770) 920-9675

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1194728048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3666 HIGHWAY 5",
            "address_2": "STE 101",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356940",
            "telephone_number": "770-942-3668",
            "fax_number": "770-920-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3666 HIGHWAY 5",
            "address_2": "STE 101",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356940",
            "telephone_number": "770-942-3668",
            "fax_number": "770-920-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBLATT",
        "first_name": "NORMAN",
        "middle_name": "I",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000344957A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.