Individual provider Active NPI

Aldo M Rosemblat, MD

  • Neurological Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1457449100
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME107703 Issued in FL
Practice address
3627 University Blvd S
Suite 415
Jacksonville, FL 32216-4230
Phone
(904) 296-2522
Fax
(904) 296-8173
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME107703 FL Primary
Neurological Surgery Physician 207T00000X 0101034243 VA

Addresses

Primary practice location

3627 University Blvd S
Suite 415
Jacksonville, FL 32216-4230

Mailing address

3627 University Blvd S
Suite 415
Jacksonville, FL 32216-4230
Phone (904) 296-2522

Other identifiers 2

IdentifierTypeStateIssuer
003887500MedicaidFL
06109594MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ALDO.ROSEMBLAT@hca5.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090313000039 PA Practitioner - Neurosurgery 6709942956 Reassigns benefits to 1 organization
I20160829001773 WI Practitioner - Neurosurgery 6709942956 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101034243VAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc CurrentSince Apr 28, 2016 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 15, 2016 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 15, 2016 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Community Medical Care, Inc Neurological Surgery Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

Interoperability endpoints

  • Direct secure messaging: aldo.rosemblat@hca5.eclinicaldirectplus.com

Organizations & group practices 5

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1457449100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S",
            "address_2": "SUITE 415",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164230",
            "telephone_number": "904-296-2522",
            "fax_number": "904-296-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S",
            "address_2": "SUITE 415",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164230",
            "telephone_number": "904-296-2522",
            "fax_number": "904-296-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEMBLAT",
        "first_name": "ALDO",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME107703",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101034243",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003887500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06109594",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ALDO.ROSEMBLAT@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "3627 University Blvd S",
            "address_2": "SUITE 415",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322164230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.