Individual provider Active NPI

Ana Maria G Blanco, D.O.

  • Family Medicine Physician
  • East Setauket, NY
National Provider Identifier
1205093374
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
261981 Issued in NY
Practice address
181 N Belle Mead Rd Ste 2
East Setauket, NY 11733-3495
Phone
(631) 444-5858
NPI assigned
May 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 261981 NY Primary

Addresses

Primary practice location

181 N Belle Mead Rd Ste 2
East Setauket, NY 11733-3495

Mailing address

181 N Belle Mead Rd Ste 2
East Setauket, NY 11733-3495
Phone (631) 444-5858

Other identifiers 2

IdentifierTypeStateIssuer
03415170MedicaidNY
A400071688OtherNYMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20120214000239 NY Practitioner - HospitalistPractitioner - Family Practice 2062679442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Suffolk Medical PCGroup PAC ID 0244396349, 204 clinicians

Practice addresses (Care Compare)

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 705-2689

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore North Ambulatory Care Center Inc Past Accepting new patients
Montefiore Medical Center Past Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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 1

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": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1205093374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 N BELLE MEAD RD STE 2",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333495",
            "telephone_number": "631-444-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 N BELLE MEAD RD STE 2",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333495",
            "telephone_number": "631-444-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "ANA MARIA",
        "middle_name": "G",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "261981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03415170",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A400071688",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.