Individual provider Active NPI

Michael Rozenblum, D.C.

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1689765406
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1290 Issued in NM
Practice address
8001 Wyoming Blvd NE
Ste. D-4
Albuquerque, NM 87113-2009
Phone
(505) 884-8584
Fax
(505) 821-8594
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1290 NM Primary

Addresses

Primary practice location

8001 Wyoming Blvd NE
Ste. D-4
Albuquerque, NM 87113-2009

Mailing address

8001 Wyoming Blvd NE
Ste. D-4
Albuquerque, NM 87113-2009
Phone (505) 884-8584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1290NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gonstead Family Chiropractic of Abq - Westside, Inc Chiropractor PastSince Jan 1, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689765406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 WYOMING BLVD NE",
            "address_2": "STE. D-4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132009",
            "telephone_number": "505-884-8584",
            "fax_number": "505-821-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 WYOMING BLVD NE",
            "address_2": "STE. D-4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132009",
            "telephone_number": "505-884-8584",
            "fax_number": "505-821-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZENBLUM",
        "first_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.