NPIMap

Individual provider Active NPI

Kevin Paul Rosenblatt, MD PHD

  • Clinical Pathology/Laboratory Medicine Physician
  • Bellaire, TX
National Provider Identifier
1689633711
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
L8178 Issued in TX
Practice address
4800 Fournace PL Ste Be13
Bellaire, TX 77401-2324
Phone
(713) 542-8592
NPI assigned
Mar 18, 2006
Last updated
Jan 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X L8178 TX Primary

Addresses

Primary practice location

4800 Fournace PL Ste Be13
Bellaire, TX 77401-2324

Mailing address

4800 Fournace PL Ste Be13
Bellaire, TX 77401-2324
Phone (713) 542-8592

Other practice location 1

4800 Fournace Pl Ste Bw2
Bellaire, TX 77401-2324
Phone (713) 542-8592

Other identifiers 2

IdentifierTypeStateIssuer
7100593530MedicaidKY
321660YV9VOtherTXMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MD, MO, OK, GA, AL, OH7 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 7

Enrollment IDStateProvider typePAC IDDetails
I20040426000861 TX Practitioner - Pathology 7113914904 Reassigns benefits to 1 organization
I20210616001954 MD Practitioner - Pathology 7113914904
I20210824000188 MO Practitioner - Pathology 7113914904 Reassigns benefits to 1 organization
I20210902000359 OK Practitioner - Pathology 7113914904
I20210917000255 GA Practitioner - Pathology 7113914904 Reassigns benefits to 1 organization
I20220318000741 AL Practitioner - Pathology 7113914904 Reassigns benefits to 1 organization
I20230511002155 OH Practitioner - Pathology 7113914904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Southwestern Medical School at Dallas, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Glenlake Pkwy S
Suite 850
Sandy Springs, GA 30328-3495
Phone (410) 834-8110

2210 Barron Rd
Poplar Bluff, MO 63901-1908
Phone (573) 727-9444

2220 Superior Via
Cleveland, OH 44113-2367
Phone (410) 834-8110

2868 Acton Rd
Vestavia, AL 35243-2502
Phone (410) 834-8110

4800 Fournace PL
Suite Be13
Bellaire, TX 77401-2324
Phone (410) 834-8110

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Health Services LLC Clinical Pathology/Laboratory Medicine CurrentSince Mar 5, 2021 Accepting new patients
Aegis Health Services LLC Current Accepting new patients
Bayside Recovery LLC Past Accepting new patients

Locations

8186 Lark Brown Rd
Ste 201
Elkridge, MD 21075
Phone (410) 834-8110

4800 Fournace Pl
#13
Bellaire, TX 77401

4800 Fournace Pl
Ste BE13
Bellaire, TX 77401
Phone (410) 834-8110

Organizations & group practices 6

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1689633711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 FOURNACE PL STE BE13",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774012324",
            "telephone_number": "713-542-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 FOURNACE PL STE BE13",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774012324",
            "telephone_number": "713-542-8592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Fournace Pl Ste Bw2",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774012324",
            "country_code": "US",
            "telephone_number": "713-542-8592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENBLATT",
        "first_name": "KEVIN",
        "middle_name": "PAUL",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "TX",
            "license": "L8178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100593530",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "321660YV9V",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

Verify at the official NPI Registry.