Individual provider Active NPI

Kendall Ann Blanck

  • Physician Assistant
  • Manchester, NH
National Provider Identifier
1396514964
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1260 Elm St
Manchester, NH 03101-1305
Phone
(603) 314-1701
NPI assigned
Dec 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1260 Elm St
Manchester, NH 03101-1305

Mailing address

172 Kinsley St
Nashua, NH 03060-3648
Phone (603) 882-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20250408001521 NH Practitioner - Physician Assistant 2567986813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Joseph Hospital of Nashua NH 271 clinicians

Practice addresses (Care Compare)

172 Kinsley St
Nashua, NH 03060-3648
Phone (603) 884-5600

Hospital & facility affiliations

  • St Joseph Hospital Hospital, Nashua, NH, CCN 300011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Hospital of Nashua NH CurrentSince Apr 2, 2025 Accepting new patients
St Joseph Hospital of Nashua NH CurrentSince Apr 2, 2025 Accepting new patients

Locations

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

Interoperability endpoints

  • Direct secure messaging: kblanck2950533@direct.bsmhealth.org

Organizations & group practices 4

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 2

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": "1703462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1396514964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 KINSLEY ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603648",
            "telephone_number": "603-882-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 ELM ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011305",
            "telephone_number": "603-314-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCK",
        "first_name": "KENDALL",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-25",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.