Active NPI
Ken Rosenblum, M.D.
- General Practice Physician
- Minneapolis, MN
National Provider Identifier
1487947248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 29880
- Practice address
- 1418 Mount Curve Ave
Minneapolis, MN 55403-1010 - Phone
- (612) 805-6180
- NPI assigned
- May 25, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 29880 | MN | Primary |
Addresses
Primary practice location
1418 Mount Curve Ave
Minneapolis, MN 55403-1010
Mailing address
1418 Mount Curve Ave
Minneapolis, MN 55403-1010
Phone (612) 805-6180
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)
- Not enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716595200000",
"number": "1487947248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1418 MOUNT CURVE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554031010",
"telephone_number": "612-805-6180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1418 MOUNT CURVE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554031010",
"telephone_number": "612-805-6180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBLUM",
"first_name": "KEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-25",
"last_updated": "2024-05-25",
"certification_date": "2024-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MN",
"license": "29880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.