NPIMap

Individual provider Active NPI

Joshua R Blomberg, M.D.

  • Orthopaedic Trauma Physician
  • Neenah, WI
National Provider Identifier
1801090071
Registry record updated Nov 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
52733 Issued in WI
Practice address
130 2ND St
Neenah, WI 54956-2883
Phone
(920) 725-0077
Fax
(920) 725-6535
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036133061 IL
Orthopaedic Trauma Physician 207XX0801X 036133061 IL
Orthopaedic Surgery Physician 207X00000X 52733 WI
Orthopaedic Trauma Physician 207XX0801X 52733 WI Primary

Addresses

Primary practice location

130 2ND St
Neenah, WI 54956-2883

Mailing address

PO Box 8003
Appleton, WI 54912-8003
Phone (920) 830-5900

Other identifiers 1

IdentifierTypeStateIssuer
036133061MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20141119000790 WI Practitioner - Orthopedic Surgery 6406083815 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

130 2ND St
Neenah, WI 54956-2883
Phone (920) 725-0077

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036133061ILMDOrthopaedic Surgery Physician
52733WIMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare Regional Medical Center - Appleton, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Thedacare Regional Medical Center - Appleton Inc. CurrentSince Mar 1, 2020 Accepting new patients
Thedacare Regional Medical Center-Neenah, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Thedacare Regional Medical Center-Neenah, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

2400 E Capitol Dr
Appleton, WI 54911
Phone (920) 731-4101

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 738-4600

3 Neenah Ctr
#101N
Neenah, WI 54956

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

130 2nd St
Ste 197
Neenah, WI 54956
Phone (920) 729-2030

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: jblomberg166191@direct.thedacare.org

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 and National Provider Directory roles.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447372800000",
    "number": "1801090071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-830-5900",
            "fax_number": "920-738-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-725-0077",
            "fax_number": "920-725-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOMBERG",
        "first_name": "JOSHUA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2015-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036133061",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "IL",
            "license": "036133061",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "52733",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "WI",
            "license": "52733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036133061",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.