Shimon Yechiel Blau, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

50730 Issued in CO

Practice address

1536 Cole Blvd Ste 120
Lakewood, CO 80401-3405

Phone

(303) 423-8334

Fax

(303) 456-1856

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Physical Medicine and RehabilitationAlso: Pain Management

Education

University of Maryland School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mile High Sports and Rehabilitation Medicine, PCGroup PAC ID 3779508551, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mile High Sports and Rehabilitation Medicine, PC

  • Physical Medicine & Rehabilitation Physician
  • Denver, CO
  • NPI 1427243146
  Medicare reassignment Care Compare group NPD
• Scott a Brandt MD PA

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Wheat Ridge, CO
  • NPI 1275604050
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1215048723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 COLE BLVD STE 120",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013405",
            "telephone_number": "303-423-8334",
            "fax_number": "303-456-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 COLE BLVD STE 120",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013405",
            "telephone_number": "303-423-8334",
            "fax_number": "303-456-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAU",
        "first_name": "SHIMON",
        "middle_name": "YECHIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "50730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO LICENSE",
            "identifier": "50730",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME107862",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Bland
• Cheryl L Blankemeier, CRNA
• Destiny Blankenship
• Thompson Kathleen Blankinship
• Luisa Carotenuto Blattner, PHD
• William R Bleau, PHD
• Mike Blechacz
• Bryan Lind Blevins, RN
• Miranda Kay Blincoe, R.N
• Heidemarie Bliss, RN

• Physical Medicine & Rehabilitation Physician in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Physical Medicine & Rehabilitation Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.