NPIMap

Organization Active NPI

Kenneth P. Goldblum, M.D., LTD.

  • Ophthalmology Physician
  • Albuquerque, NM
National Provider Identifier
1285007112
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
71-145 Issued in NM
Legal business name
KENNETH P. GOLDBLUM, M.D., LTD.
Practice address
26 Tierra Monte St NE
Albuquerque, NM 87122-2102
Phone
(505) 453-6554
NPI assigned
Oct 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Authorized official

Name
Dr. Kenneth P. Goldblum, M.D.
Title
President
Phone
(505) 205-2917

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 71-145 NM Primary

Addresses

Primary practice location

26 Tierra Monte St NE
Albuquerque, NM 87122-2102

Mailing address

26 Tierra Monte St NE
Albuquerque, NM 87122-2102
Phone (505) 453-6554

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1285007112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 TIERRA MONTE ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222102",
            "telephone_number": "505-453-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 TIERRA MONTE ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222102",
            "telephone_number": "505-453-6554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH P. GOLDBLUM, M.D., LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "GOLDBLUM",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-205-2917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NM",
            "license": "71-145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.