Individual provider Active NPI

Jeffrey D Blum, MD

  • Cardiovascular Disease Physician
  • Deerfield Beach, FL
National Provider Identifier
1669461463
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME64599 Issued in FL
Practice address
1 W Sample Rd Ste 106
Deerfield Beach, FL 33064-3547
Phone
(954) 320-2885
Fax
(954) 783-9117
NPI assigned
Oct 14, 2005
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME64599 FL Primary

Addresses

Primary practice location

1 W Sample Rd Ste 106
Deerfield Beach, FL 33064-3547

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 320-2885

Other identifiers 1

IdentifierTypeStateIssuer
373641500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080627000394 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6305923392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Eastern Virginia Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Broward Hospital DistrictGroup PAC ID 3577472422, 192 clinicians

Practice addresses (Care Compare)

1 W Sample Rd
Suite 106
Deerfield Beach, FL 33064-3547
Phone (954) 320-2885

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME64599FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Broward Hospital District Cardiovascular Disease CurrentSince Oct 1, 2018 Accepting new patients
North Broward Hospital District CurrentSince Oct 1, 2018 Accepting new patients
North Broward Hospital District Current Accepting new patients
Greater Ft Lauderdale Heart Group Cardiovascular Disease Past Accepting new patients

Locations

3100 Coral Hills Dr
Ste 302
Coral Springs, FL 33065
Phone (954) 341-5034

1 W Sample Rd
Ste 106
Deerfield Beach, FL 33064
Phone (954) 320-2885

1 W Sample Rd
Ste 301
Deerfield Beach, FL 33064
Phone (954) 320-2889

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

1700 NW 49th St
Ste 125
Ft Lauderdale, FL 33309
Phone (954) 355-3490

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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 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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1669461463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-320-2885",
            "fax_number": "954-783-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W SAMPLE RD STE 106",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330643547",
            "telephone_number": "954-320-2885",
            "fax_number": "954-783-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME64599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373641500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.