NPIMap

Individual provider Active NPI

Michael A Blum, D.O.

  • Internal Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1922082965
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS0007680 Issued in FL
Practice address
579 NW Lake Whitney Place
Suite 101
Port Saint Lucie, FL 34986-1622
Phone
(772) 249-0260
Fax
(772) 249-0137
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS0007680 FL Primary

Addresses

Primary practice location

579 NW Lake Whitney Place
Suite 101
Port Saint Lucie, FL 34986-1622

Mailing address

579 NW Lake Whitney Place
Suite 101
Port Saint Lucie, FL 34986-1622
Phone (772) 249-0260

Other identifiers 1

IdentifierTypeStateIssuer
261284400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100512000159 FL Practitioner - Internal Medicine 7214065242 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michael a Blum DO PAGroup PAC ID 2466621370, 4 clinicians
Elite Hospitalists LLCGroup PAC ID 0840559076, 2 clinicians

Practice addresses (Care Compare)

1111 SE Federal Hwy
Suite 330
Stuart, FL 34994-3839
Phone (772) 249-0260

579 NW Lake Whitney PL
Suite 101
Port St Lucie, FL 34986-1622
Phone (772) 249-0260

Hospital & facility affiliations

  • Visiting Nurse Association of Florida Inc Home health agency, Stuart, FL, CCN 107177
  • HCA Florida Healthcare at Home Home health agency, Fort Pierce, FL, CCN 107271
  • Trilogy Home Healthcare Home health agency, Port Saint Lucie, FL, CCN 109270
  • Enhabit Home Health of Jupiter Medical Center Home health agency, Jupiter, FL, CCN 107544
  • Concierge Home Care Home health agency, Port Saint Lucie, FL, CCN 687163
  • Treasure Coast Hospice of Martin Hospice, Stuart, FL, CCN 101510
  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
  • Solaris Healthcare Parkway Nursing home, Stuart, FL, CCN 105687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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 Osteopathy

State licenses

LicenseStateTypeSpecialty
OS0007680FLMDInternal Medicine Physician

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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 12

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1922082965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 NW LAKE WHITNEY PLACE",
            "address_2": "SUITE 101",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861622",
            "telephone_number": "772-249-0260",
            "fax_number": "772-249-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 NW LAKE WHITNEY PLACE",
            "address_2": "SUITE 101",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861622",
            "telephone_number": "772-249-0260",
            "fax_number": "772-249-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS0007680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261284400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.