NPIMap

Individual provider Active NPI

Michael Bublik, M.D.

  • Facial Plastic Surgery Physician
  • Glendale, CA
National Provider Identifier
1679784664
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
A112615 Issued in CA
Practice address
800 S Central Ave Ste 101B
Glendale, CA 91204-4375
Phone
(818) 649-1433
Fax
(818) 649-1436
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X A112615 CA Primary

Addresses

Primary practice location

800 S Central Ave Ste 101B
Glendale, CA 91204-4375

Mailing address

800 S Central Ave Ste 101B
Glendale, CA 91204-4375
Phone (818) 649-1433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20111005000487 CA Practitioner - Otolaryngology 3476689407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Southern California Keck School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michael Bublik MD PCGroup PAC ID 3577735075, 2 clinicians

Practice addresses (Care Compare)

800 S Central Ave
Suite 101B
Glendale, CA 91204-4375
Phone (818) 649-1433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
112615CAMDSocial Worker
A112615CAMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDFICD/Endpoint/GDFICD

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1679784664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE STE 101B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044375",
            "telephone_number": "818-649-1433",
            "fax_number": "818-649-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE STE 101B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044375",
            "telephone_number": "818-649-1433",
            "fax_number": "818-649-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBLIK",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "A112615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.