Elizabeth Ann Blank, M.D.
Individual provider Active NPI Orthopaedic Surgery Physician · Prince Frederick, MD
NPI 1043366628 · NPPES record last updated Mar 1, 2017
Key facts
- NPI
- 1043366628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- D0082740 (MD)
- Practice address
- 497 Main St
Ste 200
Prince Frederick, MD 20678-3190 - Phone
- (410) 414-9840
- Fax
- (410) 414-9841
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170330000495 | MD | Practitioner - Orthopedic Surgery | 7113242975 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0082740 | MD | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Orthopaedic Specialists, PC | Orthopaedic Surgery | Current |
Accepting new patients |
Locations
497 Main St
Ste 200
Prnc Frederck, MD 20678
Phone (410) 414-9840
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CDCECA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | |||
| Orthopaedic Surgery Physician | 207X00000X | D0082740 | MD | Yes |
Addresses
Primary practice location
497 Main St
Ste 200
Prince Frederick, MD 20678-3190
Mailing address
497 Main St
Ste 200
Prince Frederick, MD 20678-3190
Phone (410) 414-9840
Other providers in Prince Frederick, MD
- Bhargesh P. Mehta, M.D., P.a.
- Ervind Sriram Bhogte
- Bisa Wellness Center LLC
- Elizabeth Anne Bissett
- Gwendolyn Marcella Blacknall
- Amy Christine Bolger
- Bollich, LLC
- Katie Bolte
- Mary Elisabeth Rose Bailey Bonney
- Madhu Borra
All providers in Prince Frederick, MD · Orthopaedic Surgery Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.