NPIMap

Individual provider Active NPI

Neal Shanblatt, M.D.

  • Internal Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1922092410
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A64647 Issued in CA
Practice address
1304 15TH St Ste 402
Santa Monica, CA 90404-1813
Phone
(310) 451-0111
Fax
(310) 451-0202
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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 A64647 CA Primary

Addresses

Primary practice location

1304 15TH St Ste 402
Santa Monica, CA 90404-1813

Mailing address

1304 15TH St Ste 402
Santa Monica, CA 90404-1813
Phone (310) 451-0111

Other identifiers 1

IdentifierTypeStateIssuer
00A646470MedicaidCA

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
I20100917001026 CA Practitioner - Internal Medicine 0244355923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1304 15TH St
Suite 402
Santa Monica, CA 90404-1813
Phone (310) 451-0111

Hospital & facility affiliations

  • Los Angeles Home Health Care Home health agency, Los Angeles, CA, CCN 058161
  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A64647CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rephana Medical Group Internal Medicine CurrentSince May 6, 2002 Accepting new patients
The Regents of the University of California Past Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients

Locations

5850 W 3rd St
#132
Los Angeles, CA 90036

1304 15th St
Ste 402
Santa Monica, CA 90404
Phone (310) 451-0111

1260 15th St
Ste 709
Santa Monica, CA 90404
Phone (310) 451-5684

Organizations & group practices 5

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 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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1922092410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 15TH ST STE 402",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041813",
            "telephone_number": "310-451-0111",
            "fax_number": "310-451-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 15TH ST STE 402",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041813",
            "telephone_number": "310-451-0111",
            "fax_number": "310-451-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANBLATT",
        "first_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A64647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A646470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.