Individual provider Active NPI

Jessica Botero Blanco, PA-C

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1063960052
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109759 Issued in FL
Practice address
8900 North Kendall Drive
Thoracic Surgery
Miami, FL 33176
Phone
(786) 596-2000
Fax
(305) 279-7778
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109759 FL Primary

Addresses

Primary practice location

8900 North Kendall Drive
Thoracic Surgery
Miami, FL 33176

Mailing address

PO Box 198054
Atlanta, GA 30384-8054
Phone (786) 596-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161214002376 FL Practitioner - Physician Assistant 8123308855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group Physicians LLCGroup PAC ID 3870696933, 661 clinicians

Practice addresses (Care Compare)

6200 Sunset Dr
Suite 604
South Miami, FL 33143-4831
Phone (786) 662-8928

6200 SW 72 St
Suite 602
South Miami, FL 33143-4831
Phone (786) 662-0600

6200 SW 72ND St Mci Benign Urology
Suite 601
South Miami, FL 33143-4831
Phone (786) 596-2000

6200 SW 73 St
South Miami, FL 33143-4679

8900 N Kendall Dr
Miami, FL 33176-2118

Hospital & facility affiliations

  • Baptist Hospital of Miami Hospital, Miami, FL, CCN 100008
  • South Miami Hospital Hospital, Miami, FL, CCN 100154
  • Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168
  • Fishermen'S Community Hospital Hospital, Marathon, FL, CCN 101312
  • Homestead Hospital Hospital, Homestead, FL, CCN 100125

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109759FLMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1063960052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198054",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848054",
            "telephone_number": "786-596-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 NORTH KENDALL DRIVE",
            "address_2": "THORACIC SURGERY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33176",
            "telephone_number": "786-596-2000",
            "fax_number": "305-279-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "JESSICA",
        "middle_name": "BOTERO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.