Active NPI
Blair Renal Associates Inc
- Nephrology Physician
- Altoona, PA
National Provider Identifier
1043391816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- Legal business name
- BLAIR RENAL ASSOCIATES INC
- Practice address
- 501 Howard Ave
Suite D204
Altoona, PA 16601-4810 - Phone
- (814) 944-2107
- Fax
- (814) 944-6208
- NPI assigned
- Oct 18, 2006
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Dr. Marcos A. Manon, M.D.
- Title
- Ceo
- Phone
- (814) 944-2107
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040329001092 | PA | Part B Supplier - Clinic/Group Practice | 3072405489 |
Receives reassigned benefits from 5 practitioners Practice locations: Altoona, PA; Roaring Spring, PA |
National Provider Directory
National Provider DirectoryLocations
501 Howard Ave
Ste D204
Altoona, PA 16601
Phone (814) 944-2107
501 Howard Ave
Ste B110
Altoona, PA 16601
Phone (814) 943-4937
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IDACBA
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
501 Howard Ave
Suite D204
Altoona, PA 16601-4810
Mailing address
501 Howard Ave
Suite D204
Altoona, PA 16601-4810
Phone (814) 944-2107
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 9, 2014.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1402272000000",
"number": "1043391816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 HOWARD AVE",
"address_2": "SUITE D204",
"city": "ALTOONA",
"state": "PA",
"postal_code": "166014810",
"telephone_number": "814-944-2107",
"fax_number": "814-944-6208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 HOWARD AVE",
"address_2": "SUITE D204",
"city": "ALTOONA",
"state": "PA",
"postal_code": "166014810",
"telephone_number": "814-944-2107",
"fax_number": "814-944-6208"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLAIR RENAL ASSOCIATES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-18",
"last_updated": "2014-06-09",
"status": "A",
"authorized_official_last_name": "MANON",
"authorized_official_first_name": "MARCOS",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "814-944-2107",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altoona, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.