Jesus Blanco, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

56301 Issued in MA

Practice address

104 Whalon St
Suite 108
Fitchburg, MA 01420-7128

Phone

(978) 342-1150

Fax

(978) 342-4530

NPI assigned

May 1, 2006

Last updated

Feb 4, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1275590473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "WESTMINSTER",
            "state": "MA",
            "postal_code": "014730395",
            "telephone_number": "603-673-9411",
            "fax_number": "603-673-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WHALON ST",
            "address_2": "SUITE 108",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207128",
            "telephone_number": "978-342-1150",
            "fax_number": "978-342-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "JESUS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "56301",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "56301",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "B75029",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3040101",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Therese M Binyame
• Alice E Bird
• Adriana Castro Bizjak
• Kellie A Blair, MA
• Amber Elizabeth Blake
• Carrie Bland
• Howard C Blank, L.I.C.S.W.
• Kathleen Blood, LPN
• Blueprint Healthcare LLC
• Blueprint Healthcare Medical Group Pain Management

• Internal Medicine Physician in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.