Alan Arthur Goldblatt, M.D.
Individual provider Active NPI Geriatric Medicine (Internal Medicine) Physician · Aldie, VA
NPI 1689608705 · NPPES record last updated Sep 12, 2023
Key facts
- NPI
- 1689608705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician 207RG0300X
- License
- ME46925 (FL)
- Practice address
- 24419 Millstream Dr
Aldie, VA 20105-5837 - Phone
- (703) 712-4874
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170913002834 | VA | Practitioner - Internal Medicine | 0042297863 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital Palliative Care Consultants, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | ME46925 | FL | Yes |
Addresses
Primary practice location
24419 Millstream Dr
Aldie, VA 20105-5837
Mailing address
2205 NW 40TH Ter Ste B
Gainesville, FL 32605-3500
Phone (352) 375-0332
Other practice location 1
2205 NW 40th Ter
Ste B
Gainesville, FL 32605-3500
Phone (352) 375-1999
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040206100 | Medicaid | FL | |
| 30015871050001 | Medicaid | VA |
Other providers in Aldie, VA
- Amelia Indira Franklin
- Gaddipati PLLC
- Swapna Gaddipati
- Ruth Gahsu
- Javiela Francisca Galvez
- Lerah Gordon
- Shelley Green
- Belinda A Griffin
- Harika Guduru
- Almira A. Haque
All providers in Aldie, VA · Geriatric Medicine (Internal Medicine) Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.