Individual provider Active NPI

Jenny Blanco, MPH, PA-C

  • Physician Assistant
  • Miami Beach, FL
National Provider Identifier
1295070654
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107005 Issued in FL
Practice address
4306 Alton Rd
CCC 2FLR
Miami Beach, FL 33140-2840
Phone
(305) 674-2397
NPI assigned
Dec 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9107005 FL Primary
Surgical Physician Assistant 363AS0400X PA9107005 FL

Addresses

Primary practice location

4306 Alton Rd
CCC 2FLR
Miami Beach, FL 33140-2840

Mailing address

4306 Alton Rd
CCC 2FLR
Miami Beach, FL 33140-2840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130711000541 FL Practitioner - Physician Assistant 1951541135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.86 of 100Reported as group
Quality
90
Improvement activities
40
Cost
72.88

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1295070654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4306 ALTON RD",
            "address_2": "CCC 2FLR",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4306 ALTON RD",
            "address_2": "CCC 2FLR",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402840",
            "telephone_number": "305-674-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "JENNY",
        "credential": "MPH, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107005",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9107005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.