Individual provider Active NPI

Benjamin Blanco, CRNA

  • Certified Registered Nurse Anesthetist
  • Fountain Hill, PA
National Provider Identifier
1255609376
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN679646 Issued in PA
Practice address
801 Ostrum St
Fountain Hill, PA 18015-1000
Phone
(484) 526-4000
NPI assigned
Dec 3, 2011
Last updated
Jun 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN679646 PA Primary
Certified Registered Nurse Anesthetist 367500000X 26NJ00384300 NJ

Addresses

Primary practice location

801 Ostrum St
Fountain Hill, PA 18015-1000

Mailing address

14 Meadow LN
Old Bridge, NJ 08857-2563
Phone (732) 754-7733

Other practice location 1

1 RWJ Place
New Brunswick, NJ 08903
Phone (732) 828-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191017001381 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931343100 Reassigns benefits to 4 organizations
I20200610003409 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931343100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Specialists of Bethlehem PCGroup PAC ID 1355254533, 283 clinicians

Practice addresses (Care Compare)

1736 Hamilton St
Allentown, PA 18104-5656
Phone 7067379250109

1872 St Lukes Blvd
Easton, PA 18045-5669
Phone (866) 785-8537

250 S 21St St
Easton, PA 18042-3851
Phone (610) 250-4000

501 Cetronia Rd
Allentown, PA 18104-9569
Phone 7067379250109

521 Cetronia Rd
Allentown, PA 18104-9569
Phone (610) 954-5810

801 Ostrum St
Bethlehem, PA 18015-1065
Phone (610) 954-5810

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Anesthesia Physicians P.C. CurrentSince Jun 1, 2024 Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Apr 1, 2020 Accepting new patients
Bethlehem Endoscopy Center LLC CurrentSince Aug 3, 2022 Accepting new patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
Nazareth Endoscopy Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 8, 2022 Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Apr 1, 2020 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Jun 1, 2021 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Anesthesia Specialists of Bethlehem, PC Nurse Anesthetist, Certified Registered CurrentSince Jul 28, 2019 Accepting new patients

Locations

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

1736 Hamilton St
Allentown, PA 18104
Phone (610) 770-8300

24 S 18th St
Allentown, PA 18104
Phone (610) 628-8372

5325 Northgate Dr
Ste 101
Bethlehem, PA 18017
Phone (610) 866-5008

20 Community Dr
Easton, PA 18045
Phone (610) 258-1844

2401 Northampton St
Ste 220
Easton, PA 18045
Phone (610) 756-9900

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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": "1322870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1255609376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MEADOW LN",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572563",
            "telephone_number": "732-754-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 RWJ Place",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "08903",
            "country_code": "US",
            "telephone_number": "732-828-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-03",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN679646",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ00384300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.