DR. KARL R BLUM MD
NPI 1154361285
Orthopaedic Surgery - Sports Medicine in Toms River, NJ

Q: What is Karl Blum's NPI number?

The NPI number for Karl Blum is 1154361285. It was assigned to this individual provider in the NPPES registry on June 7, 2006.

Q: What is Karl Blum's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Q: When was this NPI record last updated?

The NPPES record for Karl Blum was last updated on July 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 07, 2006PECOS EnrolledAccepts Medicare Assignment

9.96/100

CMS Quality Rating

530 LAKEHURST RD STE 101, TOMS RIVER, NJ 08755(732) 349-8454(732) 341-0259 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Karl R Blum Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KARL R BLUM MD (NPI 1154361285) is an individual sports medicine provider in Toms River, New Jersey, licensed in New Jersey (25MA06431000) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Community Medical Center, and maintains a secondary practice location in Morganville.

NPPES Registry Identity

NPI1154361285

Entity TypeIndividualMale

Primary Taxonomy207XX0005X

Provider Legal NameDR. KARL R BLUMCredential: MD

Location Address530 LAKEHURST RD STE 101Toms River, NJ 08755-8063

Mailing Address530 Lakehurst Rd Ste 101Toms River, NJ 08755-8063 · (732) 349-8454 · Fax (732) 341-0259

Phone(732) 349-8454

Fax(732) 341-0259

Sole ProprietorNo

Medical School CMSRutgers New Jersey Medical SchoolGraduated 1990

Enumeration DateJune 7, 2006

Last NPPES UpdateJuly 25, 2025

NPPES CertifiedJuly 25, 2025

✔ NPI 1154361285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in NJ · 25MA06431000

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

530 LAKEHURST RD STE 101, Toms River, NJ 08755

Open in Google Maps ↗

Secondary Practice Location 1

Location 1186 County Road 520 # 1Morganville, NJ 07751-1246 · Phone (732) 349-8454 · Fax (732) 341-0259

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Karl R Blum Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729188875

PECOS Enrollment IDI20101117000519

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Karl Blum reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ocean Orthopedic Associates, P.A.

Same address

Orthopaedic Surgery

530 LAKEHURST RD
Toms River, NJ 08755

Reassigned Medicare billing, New Jersey enrollment
11 clinicians in this Medicare group

NPI 1073640454 (732) 349-8454

Hackensack Meridian Health Medical Group - Specialty Care PC

26 mi

Surgical Critical Care

331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701

Reassigned Medicare billing, New Jersey enrollment
2,844 clinicians in this Medicare group

NPI 1215989249 (732) 807-0800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 30

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

996 services465 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

533 services346 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

378 services313 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

314 services242 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

303 services209 patients

X-ray of lower and sacral spine, minimum of 4 views 72110

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

245 services238 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

226 services174 patients

Hyaluronan or derivative, gel-one, for intra-articular injection, per dose J7326

Hyaluronan or Gel-One is a substance injected directly into your joint space. It's aimed to supplement your body's natural joint fluid, helping to lubricate and cushion the joint, reducing pain and improving mobility. It's often used for arthritis relief.

198 services119 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

170 services145 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

156 services156 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

148 services99 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

85 services13 patients

X-ray of pelvis, 1-2 views 72170

An X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.

72 services72 patients

X-ray of upper spine, 2-3 views 72040

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

62 services61 patients

Fluoroscopic guidance for needle placement 77002

Fluoroscopic guidance for needle placement is a medical procedure that uses a special X-ray technology to help accurately place a needle in the body. It's often used in biopsies, injections or other treatments to ensure precision and safety.

35 services23 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

35 services34 patients

X-ray of both hips, 3-4 views 73522

An X-ray of both hips with 3-4 views is a safe imaging procedure. It involves capturing multiple pictures of your hip joints from different angles. This helps in diagnosing conditions like arthritis or fractures. You'll need to stay still during the process for clear images.

33 services32 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

29 services22 patients

X-ray of middle spine, 2 views 72070

An X-ray of the middle spine, or thoracic spine, involves capturing two different images of the area. This non-invasive procedure uses small amounts of radiation to visualize the bones and tissues in your back, helping to identify any abnormalities or injuries.

27 services26 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

26 services26 patients

X-ray of upper spine, 4-5 views 72050

An X-ray of the upper spine with 4-5 views is a non-invasive imaging test. It uses radiation to capture detailed images of the bones and structures in your neck and upper back. This procedure helps identify issues like fractures, infections, or deformities.

25 services25 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

25 services22 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

25 services22 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

24 services24 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

21 services21 patients

X-ray of elbow, minimum of 3 views 73080

An elbow X-ray with a minimum of 3 views is a non-invasive imaging test. It helps visualize the bones of the elbow from different angles. This aids in diagnosing conditions like fractures or arthritis. The procedure is quick, painless, and usually takes around 15 minutes.

19 services13 patients

Injection of trigger points, 1-2 muscles 20552

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. 1-2 muscles are typically treated in one session. The procedure involves injecting medications into these points to alleviate pain.

18 services17 patients

Aspiration and/or injection of fluid from medium joint 20605

This procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.

16 services11 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

15 services12 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Community Medical Center

Acute Care Hospitals · Toms River, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310041

Location99 Rt 37 WestToms River, NJ 08755 · Ocean County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

9.96/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

14.28

Improvement Activities

Cost

14.16

Reported Quality Measures

Risk-standardized complication rate (RSCR) following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA) for Merit-based Incentive Payment System (MIPS)

Lower rates are better for this measure.

0.02%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERT EDWARD NUGENT JR. DO

Orthopaedic Surgery