Active NPI
Jack Joseph Blumenthal, D.O.
- Surgery Physician
- Pearland, TX
National Provider Identifier
1902061674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- D5276
- Practice address
- 2550 Thelma St
Pearland, TX 77581-7081 - Phone
- (281) 485-3361
- Fax
- (281) 485-3361
- NPI assigned
- Jul 22, 2008
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | D5276 | TX | Primary |
Addresses
Primary practice location
2550 Thelma St
Pearland, TX 77581-7081
Mailing address
2550 Thelma St
Pearland, TX 77581-7081
Phone (281) 485-3361
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 |
|---|---|---|---|
| D5276 | TX | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216684800000",
"number": "1902061674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2550 THELMA ST",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775817081",
"telephone_number": "281-485-3361",
"fax_number": "281-485-3361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 THELMA ST",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775817081",
"telephone_number": "281-485-3361",
"fax_number": "281-485-3361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUMENTHAL",
"first_name": "JACK",
"middle_name": "JOSEPH",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-22",
"last_updated": "2008-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "D5276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.