Individual provider Active NPI

Ronald J Blumenfeld, M.D.

  • Specialist
  • El Paso, TX
National Provider Identifier
1477550861
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D4715 Issued in TX
Practice address
4305 N Mesa St Ste B
El Paso, TX 79902-1124
Phone
(915) 779-7378
Fax
(915) 779-2822
NPI assigned
Jun 30, 2005
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D4715 TX Primary
Otolaryngology Physician 207Y00000X D4715 TX

Addresses

Primary practice location

4305 N Mesa St Ste B
El Paso, TX 79902-1124

Mailing address

4305 N Mesa St Ste B
El Paso, TX 79902-1124
Phone (915) 779-7378

Other practice location 1

3030 Joe Battle Blvd
El Paso, TX 79938-2667
Phone (915) 242-1634

Other practice location 2

1733 Curie Dr
El Paso, TX 79902-2909
Phone (915) 533-5461

Other identifiers 1

IdentifierTypeStateIssuer
114996504MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20100601000690 TX Practitioner - Otolaryngology 6305975301

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gonzalo a Diaz CurrentSince Oct 20, 2017 Accepting new patients

Locations

3030 Joe Battle Blvd
El Paso, TX 79938
Phone (915) 242-1634

4305 N Mesa St
Ste B
El Paso, TX 79902
Phone 91577973781024

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1477550861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 N MESA ST STE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021124",
            "telephone_number": "915-779-7378",
            "fax_number": "915-779-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 N MESA ST STE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021124",
            "telephone_number": "915-779-7378",
            "fax_number": "915-779-2822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Joe Battle Blvd",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799382667",
            "country_code": "US",
            "telephone_number": "915-242-1634",
            "fax_number": "915-242-1651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1733 Curie Dr",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799022909",
            "country_code": "US",
            "telephone_number": "915-533-5461",
            "fax_number": "915-544-1603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUMENFELD",
        "first_name": "RONALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "D4715",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "D4715",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114996504",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.