Active NPI
Robert J Blender, LSW
- Social Worker
- Indianapolis, IN
National Provider Identifier
1669403531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 33004990A
- Practice address
- 2620 Kessler Boulevard East Dr
Indianapolis, IN 46220-2890 - Phone
- (317) 475-6200
- Fax
- (317) 962-6212
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 33004990A | IN | Primary |
Addresses
Primary practice location
2620 Kessler Boulevard East Dr
Indianapolis, IN 46220-2890
Mailing address
950 N Meridian St
Suite 300
Indianapolis, IN 46204-1077
Phone (317) 962-4836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150821012919 | MI | Practitioner - Clinical Social Worker | 0042525933 | Practice locations: Royal Oak, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1320 N Campbell Rd
Suite 6
Royal Oak, MI 48067-1555
Phone (317) 507-0433
1750 S Telegraph Rd
Suite 101
Bloomfield Hills, MI 48302-0177
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33004990A | IN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669403531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 N MERIDIAN ST",
"address_2": "SUITE 300",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462041077",
"telephone_number": "317-962-4836",
"fax_number": "317-962-4812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 KESSLER BOULEVARD EAST DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462202890",
"telephone_number": "317-475-6200",
"fax_number": "317-962-6212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLENDER",
"first_name": "ROBERT",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "33004990A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.