Jeffrey Ray Blumenthal, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD017878E Issued in PA

Practice address

333 N Oxford Valley Rd
Ste 201
Fairless Hills, PA 19030-2624

Phone

(215) 946-1500

Fax

(215) 946-3417

NPI assigned

Jun 20, 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 7

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffrey.blumenthal.1@11127.direct.athenahealth.com

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.

• Trinity Health Mid-Atlantic Medical Group

  • Surgery Physician
  • Langhorne, PA
  • NPI 1972982361

  PA

  Medicare reassignment NPD
• Trinity Health Mid-Atlantic Medical Group

  • Geriatric Medicine (Internal Medicine) Physician
  • Langhorne, PA
  • NPI 1013225903
  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
  • NPI 1639039175
  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Family Medicine Physician
  • Holland, PA
  • NPI 1144521444
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1376589457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNIVERSITY DR",
            "address_2": "SUITE 300",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401873",
            "telephone_number": "215-946-1500",
            "fax_number": "215-946-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N OXFORD VALLEY RD",
            "address_2": "STE 201",
            "city": "FAIRLESS HILLS",
            "state": "PA",
            "postal_code": "190302624",
            "telephone_number": "215-946-1500",
            "fax_number": "215-946-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMENTHAL",
        "first_name": "JEFFREY",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD017878E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007341320005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE FIRST",
            "identifier": "30230773",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01193807",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE IBC",
            "identifier": "0022028000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PA",
            "identifier": "9647552",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "058803",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4218767",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffrey.blumenthal.1@11127.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "SMMC Direct E-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "333 N Oxford Valley Rd",
            "address_2": "Ste 201",
            "city": "Fairless Hills",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190302624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Surbhi Bhatia, D.D.S.
• Jean Bichara, DDS, MS
• BJ'S Wholesale Club Inc.
• BJS Wholesale Club Inc
• Blue Rose Home Care, LLC
• BMC Primary Care Physicians LLC
• Harshil Boghara, DMD
• Yash Boghara, DMD
• Bonner Sports and Physical Medicine, Inc..
• Meghan Bonner, CRNP

• All providers in Fairless Hills, PA
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.