NPIMap

Individual provider Active NPI

Richard Anthony Blumengold, MD

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1922686823
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME168216 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1096
Phone
(305) 858-1111
Fax
(800) 792-9021
NPI assigned
Mar 31, 2021
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X ME168216 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1096

Mailing address

8201 W Broward Blvd
Plantation, FL 33324-2701
Phone (954) 723-1206

Other practice location 1

8201 W Broward Blvd
Plantation, FL 33324-2701
Phone (954) 473-6600

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
I20240813000108 FL Practitioner - Internal Medicine 6800334665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HHA Associates LLCGroup PAC ID 2961839758, 125 clinicians

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (786) 466-2940

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME168216FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HHA Associates LLC CurrentSince Jul 31, 2024 Accepting new patients

Locations

3476 S University Dr
Davie, FL 33328
Phone (954) 475-4350

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

4960 SW 72nd Ave
Ste 301
Miami, FL 33155

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1922686823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242701",
            "telephone_number": "954-723-1206",
            "fax_number": "954-452-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361096",
            "telephone_number": "305-858-1111",
            "fax_number": "800-792-9021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8201 W Broward Blvd",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333242701",
            "country_code": "US",
            "telephone_number": "954-473-6600",
            "fax_number": "800-792-9021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUMENGOLD",
        "first_name": "RICHARD",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME168216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.