Michael Ryan Blanco, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02105400 Issued in NJ

Practice address

31 Ver Valen St
Closter, NJ 07624-2699

Phone

(201) 784-2700

NPI assigned

Aug 8, 2022

Last updated

Aug 8, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Spine and Health Center of Closter PC

  • Chiropractor
  • Closter, NJ
  • NPI 1497291728

  Physical Therapist

  Medicare reassignment NPD
• The Spine and Health Center of Montvale

  • Chiropractor
  • Montvale, NJ
  • NPI 1205085024

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1104553262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 AUSTIN PL",
            "city": "HASBROUCK HEIGHTS",
            "state": "NJ",
            "postal_code": "076041438",
            "telephone_number": "201-220-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 VER VALEN ST",
            "city": "CLOSTER",
            "state": "NJ",
            "postal_code": "076242699",
            "telephone_number": "201-784-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "MICHAEL",
        "middle_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02105400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman G Bartner, DMD
• Bergen Healthcare LLC
• Bergen Home Care LLC (Comfort Keepers)
• Bergen Orthodontic Assoc., PA
• Bergen Orthopaedic Surgery & Sports Medicine
• Mona Teresa Lynch Boland, APN
• Kelly Ann Braun, LCSW
• David Christopher Buckner, LMT
• Magdealena Buczek, DPT
• Jonathan S Byrne, LCSW

• Physical Therapist in Closter, NJ
• Providers in Closter, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.

Verify at the official NPI Registry.