Individual provider Active NPI

David L. Grinblatt, MD

  • Hematology (Internal Medicine) Physician
  • Evanston, IL
National Provider Identifier
1548285372
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
036077054 Issued in IL
Practice address
2650 Ridge Ave.
Kellogg Cancer Center
Evanston, IL 60201
Phone
(847) 570-2112
Fax
(847) 570-1041
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 036077054 IL Primary

Addresses

Primary practice location

2650 Ridge Ave.
Kellogg Cancer Center
Evanston, IL 60201

Mailing address

2650 Ridge Ave.
Kellogg Cancer Center
Evanston, IL 60201-1718
Phone (847) 570-2112

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgrinblatt16219@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20050804000513 IL Practitioner - HematologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 9739118373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1300 Oak Ave
Evanston, IL 60201-4205
Phone (847) 869-1300

2180 Pfingsten Rd
Glenview, IL 60026-1339

2650 Ridge Ave
Evanston, IL 60201-1700

2739 W Foster Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

5145 N California
Hosps Suite 331
Chicago, IL 60625-3661
Phone (847) 570-2280

5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

777 Park Ave W
Highland Park, IL 60035-2433

Hospital & facility affiliations

  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036077054ILMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince May 1, 2002 Accepting new patients
Endeavor Health Medical Group CurrentSince May 1, 2002 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2180 Pfingsten Rd
Glenview, IL 60026
Phone (847) 503-1000

Interoperability endpoints

  • Direct secure messaging: dgrinblatt16219@direct.northshore.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1548285372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "KELLOGG CANCER CENTER",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2112",
            "fax_number": "847-570-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "KELLOGG CANCER CENTER",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-2112",
            "fax_number": "847-570-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINBLATT",
        "first_name": "DAVID",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "IL",
            "license": "036077054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgrinblatt16219@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2650 Ridge Ave.",
            "address_2": "Kellogg Cancer Center",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.