Charles Howard Kornblau, MD is a medicare enrolled "Internal Medicine" physician in Woodridge, New York. His current practice location is
2 First Street, Woodridge, New York. You can reach out to his office (for appointments etc.) via phone at
(845) 434-3277.
Charles Howard Kornblau is licensed to practice in Michigan (license number 4301094020) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1356585780.
Physician's Profile
Full Name | Charles Howard Kornblau |
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Gender | Male |
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Speciality | Internal Medicine |
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Location | 2 First Street, Woodridge, New York |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1356585780
- Provider Enumeration Date: 04/29/2009
- Last Update Date: 07/30/2020
Medicare PECOS Information:
- PECOS PAC ID: 2668515677
- Enrollment ID: I20170920003732
Medical Identifiers
Medical identifiers for Charles Howard Kornblau such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1356585780 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208M00000X | Hospitalist | 4301094020 (Michigan) | Secondary |
207R00000X | Internal Medicine | 4301094020 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charles Howard Kornblau allows following entities to bill medicare on his behalf.
Entity Name | Pine Ridge Indian Health Service Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1497786412 PECOS PAC ID: 4688571326 Enrollment ID: O20031218000966 |
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Entity Name | The Fort Defiance Indian Hospital Board, Incorporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1477876639 PECOS PAC ID: 0941336697 Enrollment ID: O20100429001153 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charles Howard Kornblau is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Charles Howard Kornblau, MD Po Box 101, Woodridge, NY 12789-0101 Ph: (845) 434-3277 | Charles Howard Kornblau, MD 2 First Street, Woodridge, NY 12789-0101 Ph: (845) 434-3277 |
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