Individual provider Active NPI

Eric R Blanson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Shenandoah, TX
National Provider Identifier
1215285135
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
T28-2012 Issued in TX
Practice address
128 Vision Park Blvd Ste 135
Shenandoah, TX 77384-3017
Phone
(832) 585-1620
Fax
(855) 787-3211
NPI assigned
Aug 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X T28-2012 TX Primary

Addresses

Primary practice location

128 Vision Park Blvd Ste 135
Shenandoah, TX 77384-3017

Mailing address

128 Vision Park Blvd Ste 135
Shenandoah, TX 77384-3017
Phone (832) 585-1620

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140918000582 TX Practitioner - Podiatry 7214156561 Reassigns benefits to 1 organization
Practice locations: Shenandoah, TX

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 N Brand Blvd
Suite 522
Glendale, TX 77384-3033

128 Vision Park Blvd
Suite 135
Shenandoah, TX 77384-3017

128 Vision Park Blvd
Suite 135
Shenandoah, TX 77384-3033
Phone (832) 585-1620

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue21
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T28-2012TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
PMC Foot and Ankle Clinic PA Foot & Ankle Surgery CurrentSince Apr 6, 2019 Accepting new patients

Locations

128 Vision Park Blvd
Ste 135
Shenandoah, TX 77384
Phone (832) 585-1620

26710 Interstate 45
Ste B
Spring, TX 77386
Phone (281) 419-1117

Interoperability endpoints

  • Direct secure messaging: eric.blanson.1@11939.direct.athenahealth.com

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 3

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": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1215285135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 VISION PARK BLVD STE 135",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843017",
            "telephone_number": "832-585-1620",
            "fax_number": "855-787-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 VISION PARK BLVD STE 135",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843017",
            "telephone_number": "832-585-1620",
            "fax_number": "855-787-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANSON",
        "first_name": "ERIC",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-27",
        "last_updated": "2024-05-08",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "T28-2012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.