Individual provider Active NPI

Benjamin L Kornblatt, D.O.

  • Anesthesiology Physician
  • Savannah, GA
National Provider Identifier
1942566740
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
076305 Issued in GA
Practice address
5353 Reynolds St
Savannah, GA 31405-6015
Phone
(912) 355-7214
Fax
(912) 354-2479
NPI assigned
Apr 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0102205062 VA
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 076305 GA Primary

Addresses

Primary practice location

5353 Reynolds St
Savannah, GA 31405-6015

Mailing address

PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839

Other practice location 1

44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171222000770 VA Practitioner - Anesthesiology 6305134065 Reassigns benefits to 2 organizations
I20230712002204 DC Practitioner - Anesthesiology 6305134065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMG Anesthesia Specialists LLCGroup PAC ID 6305081118, 501 clinicians

Practice addresses (Care Compare)

2010 Health Campus Dr
Rockingham, VA 22801-8679
Phone (434) 654-5000

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 507-1000

Hospital & facility affiliations

  • Sentara RMH Medical Center Hospital, Harrisonburg, VA, CCN 490004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
076305GAMDAnesthesiology Physician
0102205062VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMG Anesthesia Specialists LLC Anesthesiology CurrentSince Sep 21, 2020 Accepting new patients
Inova Cares - Community Anesthesiology CurrentSince Jun 12, 2023 Accepting new patients

Locations

500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

2010 Health Campus Dr
Rockingham, VA 22801
Phone (540) 689-1000

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

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 1

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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1942566740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "855-851-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 REYNOLDS ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056015",
            "telephone_number": "912-355-7214",
            "fax_number": "912-354-2479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44045 Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201765101",
            "country_code": "US",
            "telephone_number": "703-858-6000",
            "fax_number": "703-858-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNBLATT",
        "first_name": "BENJAMIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-05",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0102205062",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "076305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.