Active NPI
Paul Blumberg, DO
- Facial Plastic Surgery Physician
- Scottsdale, AZ
National Provider Identifier
1790087955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Facial Plastic Surgery Physician
- License
- 1597
- Practice address
- 10135 E Wethersfield Rd
Scottsdale, AZ 85260-5132 - Phone
- (602) 980-0174
- NPI assigned
- Nov 21, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Facial Plastic Surgery Physician | 207YS0123X | 1597 | AZ | Primary |
Addresses
Primary practice location
10135 E Wethersfield Rd
Scottsdale, AZ 85260-5132
Mailing address
10135 E Wethersfield Rd
Scottsdale, AZ 85260-5132
Phone (602) 980-0174
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1597 | AZ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290297600000",
"number": "1790087955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10135 E WETHERSFIELD RD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852605132",
"telephone_number": "602-980-0174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10135 E WETHERSFIELD RD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852605132",
"telephone_number": "602-980-0174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUMBERG",
"first_name": "PAUL",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-21",
"last_updated": "2010-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207YS0123X",
"taxonomy_group": "",
"desc": "Otolaryngology, Facial Plastic Surgery",
"state": "AZ",
"license": "1597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.