Adam Blatt MD Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A111452 Issued in CA

Legal business name

ADAM BLATT MD INC

Practice address

1401 Avocado Ave Ste 602
Newport Beach, CA 92660-7715

Phone

(949) 644-8722

Fax

(949) 644-8893

NPI assigned

Jun 26, 2018

Organization subpart

No

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

Authorized official

Name

Adam M Blatt, MDNPI 1942451992

Title

President

Phone

(949) 644-8722

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adam Michael Blatt, MD

  • Urology Physician
  • Newport Beach, CA
  • NPI 1942451992

  CA, Urology

  Medicare reassignment NPD Authorized official
• Robert J Bae, M.D.

  • Urology Physician
  • Newport Beach, CA
  • NPI 1467433326

  Urology

  NPD

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1982199584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE STE 602",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607715",
            "telephone_number": "949-644-8722",
            "fax_number": "949-644-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE STE 602",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607715",
            "telephone_number": "949-644-8722",
            "fax_number": "949-644-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAM BLATT MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-11-01",
        "status": "A",
        "authorized_official_last_name": "BLATT",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-644-8722",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A111452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daisy Acosta
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• Activecarerx Wellness, LLC
• Kristi Acuna, BSNU
• Adam M. Rotunda, M.D., a Professional Corporation
• Michael Adams, LAC
• Victoria Adams
• Jory Adamson, MFT
• Addiction Specialist of Southern California, Inc.

• All providers in Newport Beach, CA
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.