Active NPI
Nina Blum, MD
- Internal Medicine Physician
- Tavares, FL
National Provider Identifier
1922533256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME156627
- Practice address
- 1613 Banning Beach Rd
Tavares, FL 32778-2024 - Phone
- (352) 343-7735
- NPI assigned
- Apr 24, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME156627 | FL | Primary |
Addresses
Primary practice location
1613 Banning Beach Rd
Tavares, FL 32778-2024
Mailing address
1613 Banning Beach Rd
Tavares, FL 32778-2024
Phone (352) 343-7735
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | ninastarkblum@gmail.com | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220810003901 | FL | Practitioner - Rheumatology | 9739452731 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kenneth E Stark MD PA
Practice addresses (Care Compare)
1613 Banning Beach Rd
Tavares, FL 32778-2024
Phone (352) 373-7735
Hospital & facility affiliations
- Adventhealth Waterman
- Adventhealth Orlando
- Orlando Health South Lake Hospital
- Adventhealth Daytona Beach
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.11 of 100
- Quality
- 98.21
- Improvement activities
- 40
- Cost
- 76.32
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Rheumatology | Current | Accepting new patients |
Locations
1613 Banning Beach Rd
Tavares, FL 32778
Phone (352) 343-7735
Organizations & group practices 1
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 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
Hospital
-
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665360000000",
"number": "1922533256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1613 BANNING BEACH RD",
"city": "TAVARES",
"state": "FL",
"postal_code": "327782024",
"telephone_number": "352-343-7735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1613 BANNING BEACH RD",
"city": "TAVARES",
"state": "FL",
"postal_code": "327782024",
"telephone_number": "352-343-7735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUM",
"first_name": "NINA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-24",
"last_updated": "2022-10-10",
"certification_date": "2022-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME156627",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "ninastarkblum@gmail.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "email",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "1613 Banning Beach Rd",
"city": "Tavares",
"state": "FL",
"country_code": "US",
"postal_code": "327782024",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tavares, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.