Martin M Blanco-Eccleston, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A42392 Issued in CA

Practice address

500 S Anaheim Hills Rd
Suite 230
Anaheim, CA 92807-4780

Phone

(714) 974-2820

Fax

(714) 974-1539

NPI assigned

Sep 20, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1968

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Primary and Multi-Specialty Clinics of AnaheimGroup PAC ID 9638136096, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: martinblancoeccleston@ngmai.allscriptsdirect.net

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.

• Primary and Multi Specialty Clinics of Anaheim Inc

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1053408278
  Medicare reassignment Care Compare group NPD
• Amg, a Professional Medical Corporation

  • Internal Medicine Physician
  • Alhambra, CA
  • NPI 1558306266

  Family Medicine

  Medicare reassignment NPD
• Metropolitan Ipa

  • Home Health Agency
  • Anaheim, CA
  • NPI 1417208141

  Family Medicine

  NPD
• Primary and Multi Specialty Clinics of Anaheim Inc

  • Primary Care Clinic/Center
  • Anaheim, CA
  • NPI 1386356178
  NPD
• Alta Newport Hospital, LLC

  • General Acute Care Hospital
  • Tustin, CA
  • NPI 1043632938
  NPD (past)
• Anaheim Memorial Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1295782381
  NPD (past)
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1164520326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S ANAHEIM HILLS RD",
            "address_2": "SUITE 230",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074780",
            "telephone_number": "714-974-2820",
            "fax_number": "714-974-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S ANAHEIM HILLS RD",
            "address_2": "SUITE 230",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074780",
            "telephone_number": "714-974-2820",
            "fax_number": "714-974-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO-ECCLESTON",
        "first_name": "MARTIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A42392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG",
            "identifier": "154-668-8",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A423920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Blair
• Emily Blake
• Mary Blake
• Blanca B. Hampton, M.D.
• Deanna Michelle Blanchard
• April Blanco
• Brian Paul Blanco, PT, DPT
• Diana Blanco
• Samuel Blanco
• Natalie Bland, NP

• Family Medicine Physician in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.