Jose Angel Blanco de Jesus Sr., MD
Individual provider Active NPI General Practice Physician · Ponce, PR
NPI 1154430825 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154430825
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 10080 (PR)
- Practice address
- 1255 Tito Castro Ave
Plaza Las Monjitas Suite 204
Ponce, PR 00730 - Phone
- (787) 844-7336
- Fax
- (787) 844-7336
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- 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 |
|---|---|---|---|---|
| I20110302000664 | PR | Practitioner - General Practice | 8527249101 |
Reassigns benefits to 1 organization Practice locations: Ponce, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Anesthesia Associates LLC | Current | Accepting new patients | |
| Hospital Damas Inc | Current |
Accepting new patients | |
| Rad Nucs LLC | Past | Accepting new patients | |
| Yauco Healthcare Corporation | Past | Accepting new patients |
Locations
2213 Ponce Byp
Ponce, PR 00717
Phone (787) 368-7802
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 10080 | PR | Yes |
Addresses
Primary practice location
1255 Tito Castro Ave
Plaza Las Monjitas Suite 204
Ponce, PR 00730
Mailing address
2060 Colina St
Urb Valle Alto
Ponce, PR 00730-4139
Phone (787) 259-2496
Other providers in Ponce, PR
- Bio-Medical Applications of Arecibo, Inc.
- Bio-Medical Applications of Ponce, Inc.
- Bio-Medical Applications of Puerto Rico, Inc.
- Juana D Bisono-Bido
- Malynie D Blanco Burgos
- Edda Maria Blanco Rodriguez
- Arturo Luis Blanco-Plard
- Ivonne Magaly Blasini
- Ricardo J Blondet Vissepo
- Bluemind LLC
All providers in Ponce, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.