Individual provider Active NPI

Gerald Arthur Rosenblum, MD

  • Dermatology Physician
  • Phoenix, AZ
National Provider Identifier
1386648350
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
10268 Issued in AZ
Practice address
5056 N Central Ave
Phoenix, AZ 85012-1521
Phone
(602) 222-9111
Fax
(602) 222-9333
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 10268 AZ Primary

Addresses

Primary practice location

5056 N Central Ave
Phoenix, AZ 85012-1521

Mailing address

6201 N 42ND St
Paradise Valley, AZ 85253-3962
Phone (602) 380-2817

Other identifiers 3

IdentifierTypeStateIssuer
0830040OtherAZBCBS
219271MedicaidAZ
219271OtherAZMERCY CARE

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

LicenseStateTypeSpecialty
10268AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Skin II PC Dermatology PastSince Dec 1, 1997 Accepting new patients
Squaw Peak Anesthesia Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386648350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 N 42ND ST",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852533962",
            "telephone_number": "602-380-2817",
            "fax_number": "602-224-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5056 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121521",
            "telephone_number": "602-222-9111",
            "fax_number": "602-222-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBLUM",
        "first_name": "GERALD",
        "middle_name": "ARTHUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "10268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0830040",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219271",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY CARE",
            "identifier": "219271",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.