NPIMap

Individual provider Active NPI

Keith S Blum, DO

  • Neurological Surgery Physician
  • Las Vegas, NV
National Provider Identifier
1558417345
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
1121 Issued in NV
Practice address
7271 West Sahara
Suite 100
Las Vegas, NV 89117
Phone
(702) 240-4090
Fax
(702) 240-4091
NPI assigned
Jan 26, 2007
Last updated
Feb 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 1121 NV Primary

Addresses

Primary practice location

7271 West Sahara
Suite 100
Las Vegas, NV 89117

Mailing address

7271 West Sahara
Suite 100
Las Vegas, NV 89117-2753
Phone (702) 240-4090

Other identifiers 2

IdentifierTypeStateIssuer
100502549MedicaidNV
1456305995OtherNVBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040512000436 NV Practitioner - Neurosurgery 3577552843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Michigan State University College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 731-8000

5400 S Rainbow Blvd
Las Vegas, NV 89118-1859
Phone (702) 853-3000

6900 N Durango Dr
Las Vegas, NV 89149-4409
Phone (702) 835-9700

7271 W Sahara Ave
Suite 100
Las Vegas, NV 89117-2862
Phone (702) 240-4090

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1121NVMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
James Heinsimer MD PC PastSince Aug 11, 2000 Accepting new patients
Southeast Michigan Neurosurgery PLLC Neurological Surgery Past Accepting new patients
Keith S Blum DO PC Past Accepting new patients
Keith S Blum DO PC Neurological Surgery Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13361/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/GBIADA/Endpoint/GBIADA
  • Direct secure messaging: kblum13228@direct.umcsn.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1558417345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7271 WEST SAHARA",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172753",
            "telephone_number": "702-240-4090",
            "fax_number": "702-240-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7271 WEST SAHARA",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89117",
            "telephone_number": "702-240-4090",
            "fax_number": "702-240-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "KEITH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NV",
            "license": "1121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502549",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1456305995",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.