NPIMap

Individual provider Active NPI

Michael Blam, MD

  • Gastroenterology Physician
  • Long Beach, CA
National Provider Identifier
1801877733
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
039355 Issued in CT
Practice address
2925 Palo Verde Ave
Long Beach, CA 90815-1552
Phone
(562) 429-2473
NPI assigned
Nov 8, 2005
Last updated
Jan 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 039355 CT Primary

Addresses

Primary practice location

2925 Palo Verde Ave
Long Beach, CA 90815-1552

Mailing address

2925 Palo Verde Ave
Long Beach, CA 90815-1552
Phone (562) 429-2473

Other identifiers 1

IdentifierTypeStateIssuer
001393553MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100922000977 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 5092871616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Washington University School of Medicine, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Gastro-Digestive Medical GroupGroup PAC ID 8325030406, 3 clinicians

Practice addresses (Care Compare)

11480 Brookshire Ave
Suite 308
Downey, CA 90241-5025
Phone (562) 862-3656

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.15 of 100Reported as group
Quality
78.12
Improvement activities
40
Cost
83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy94
Upper gastrointestinal (GI) endoscopy for acid reflux200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro-Digestive Medical Group Gastroenterology CurrentSince Aug 8, 2016 Accepting new patients
University of California Irvine Past Accepting new patients
Dignity Health Past Accepting new patients
St Francis Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Yale New Haven Hospital Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Talbert Medical Group, P.C. Past Accepting new patients
Saint Raphael Faculty Physicians Gastroenterology Past Accepting new patients

Locations

11480 Brookshire Ave
Ste 308
Downey, CA 90241
Phone (562) 862-3656

3621 Martin Luther King Jr Blvd
Ste 5
Lynwood, CA 90262
Phone (310) 632-0906

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJEEBA

Organizations & group practices 10

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1801877733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 PALO VERDE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151552",
            "telephone_number": "562-429-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 PALO VERDE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151552",
            "telephone_number": "562-429-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAM",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "039355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001393553",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.