NPIMap

Organization Active NPI

Alan a Goldblatt MD PA

  • Geriatric Medicine (Internal Medicine) Physician
  • Gainesville, FL
National Provider Identifier
1891725628
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
ALAN A GOLDBLATT MD PA
Practice address
2205 NW 40TH Ter
Ste B
Gainesville, FL 32605-3500
Phone
(352) 375-1999
Fax
(352) 375-1677
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

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

Authorized official

Name
Alan Goldblatt, M.D.
Title
President/Owner
Phone
(352) 375-0332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

2205 NW 40TH Ter
Ste B
Gainesville, FL 32605-3500

Mailing address

PO Box 147050
PMB 519
Gainesville, FL 32614-7050
Phone (352) 375-0332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040630000513 FL Part B Supplier - Clinic/Group Practice 6406833219 Receives reassigned benefits from 5 practitioners
Practice locations: Gainesville, FL; Trenton, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297987200000",
    "number": "1891725628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147050",
            "address_2": "PMB 519",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326147050",
            "telephone_number": "352-375-0332",
            "fax_number": "352-375-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 NW 40TH TER",
            "address_2": "STE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326053500",
            "telephone_number": "352-375-1999",
            "fax_number": "352-375-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN A GOLDBLATT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-02-18",
        "status": "A",
        "authorized_official_last_name": "GOLDBLATT",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "352-375-0332",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.