Individual provider Active NPI

Joseph Anthony Blanco, MD

  • Ophthalmology Physician
  • Manhasset, NY
National Provider Identifier
1023113339
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
139397 Issued in NY
Practice address
133 Plandome Road
Manhasset, NY 11030
Phone
(516) 627-0033
Fax
(516) 627-7354
NPI assigned
Sep 13, 2006
Last updated
Sep 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 139397 NY Primary

Addresses

Primary practice location

133 Plandome Road
Manhasset, NY 11030

Mailing address

133 Plandome Road
Manhasset, NY 11030
Phone (516) 627-0033

Other identifiers 1

IdentifierTypeStateIssuer
0709499MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000052 NY Practitioner - Ophthalmology 4284809823 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sight Medical Doctors PLLC Ophthalmology CurrentSince May 7, 2019 Accepting new patients
Sight Medical Doctors PLLC CurrentSince May 7, 2019 Accepting new patients

Locations

125 Kennedy Dr
Ste 400
Hauppauge, NY 11788

133 Plandome Rd
Plandome, NY 11030
Phone (516) 482-3080

260 E Middle Country Rd
Ste 201
Smithtown, NY 11787
Phone 6312658780150

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1023113339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 PLANDOME ROAD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "11030",
            "telephone_number": "516-627-0033",
            "fax_number": "516-627-7354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 PLANDOME ROAD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "11030",
            "telephone_number": "516-627-0033",
            "fax_number": "516-627-7354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "JOSEPH",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "139397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0709499",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.