NPIMap

Individual provider Active NPI

Ira Kornbluth, M.D.

  • Interventional Pain Medicine Physician
  • Owings Mills, MD
National Provider Identifier
1609872266
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
D0061293 Issued in MD
Practice address
7920 McDonogh Rd
Suite 201
Owings Mills, MD 21117-5273
Phone
(443) 693-7246
Fax
(866) 906-5997
NPI assigned
Jun 28, 2005
Last updated
Jun 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X D0061293 MD Primary

Addresses

Primary practice location

7920 McDonogh Rd
Suite 201
Owings Mills, MD 21117-5273

Mailing address

7920 McDonogh Rd
Suite 210
Owings Mills, MD 21117-5273
Phone (443) 693-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040629000395 MD Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain ManagementPractitioner - Pain Management 1850377961 Reassigns benefits to 1 organization
I20071101000062 DC Practitioner - Interventional Pain Management 1850377961 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0061293MDMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Management Specialists, LLC Interventional Pain Medicine CurrentSince Aug 1, 2017 Accepting new patients
Advanced Pain Management Specialists, LLC Interventional Pain Medicine CurrentSince Sep 14, 2017 Accepting new patients
Smart Pain Surgery Center at White Marsh PastSince Apr 12, 2016 Accepting new patients
Deck Pain Management , LLC Interventional Pain Medicine Past Accepting new patients
Advanced Pain Management Specialists, LLC Past Accepting new patients
Clearway Surgery Center of Easton, LLC PastSince Sep 21, 2020 Accepting new patients
Frederick Health Hospital Inc Interventional Pain Medicine Past Accepting new patients
Clearway Surgery Center of Largo LLC PastSince Sep 21, 2023 Accepting new patients
ASC Development Company, LLC Past Accepting new patients
Bay Surgery Centers - Waldorf, LLC PastSince Aug 14, 2017 Accepting new patients
Smart Pain Surgery Center at Germantown, LLC PastSince Jan 26, 2015 Accepting new patients
Spine Medicine and Rehab Past Accepting new patients
Clearway Surgery Center of St. Marys LLC PastSince May 20, 2024 Accepting new patients
Clearway Surgery Center of Hagerstown, LLC PastSince Feb 1, 2024 Accepting new patients

Locations

810 Bestgate Rd
Ste 220
Annapolis, MD 21401
Phone (800) 997-2460

19801 Observation Dr
Germantown, MD 20876
Phone (301) 557-5928

19851 Observation Dr
Ste 360
Germantown, MD 20876

8100 Sandpiper Cir
Ste 214
Nottingham, MD 21236
Phone (443) 442-0500

7920 McDonogh Rd
Ste 201
Owings Mills, MD 21117
Phone (443) 321-2590

120 Sallitt Dr
#D
Stevensville, MD 21666
Phone (410) 923-2714

826 Washington Rd
Ste 210
Westminster, MD 21157
Phone (410) 346-5163

Interoperability endpoints

  • Direct secure messaging: ira.kornbluth.1@11679.direct.athenahealth.com

Organizations & group practices 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1609872266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 MCDONOGH RD",
            "address_2": "SUITE 210",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175273",
            "telephone_number": "443-693-7246",
            "fax_number": "866-906-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 MCDONOGH RD",
            "address_2": "SUITE 201",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175273",
            "telephone_number": "443-693-7246",
            "fax_number": "866-906-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBLUTH",
        "first_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MD",
            "license": "D0061293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.