Individual provider Active NPI

Ernesto Blanco, M.D.

  • Diagnostic Radiology Physician
  • San Antonio, TX
National Provider Identifier
1508843392
Registry record updated Jul 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
E4210 Issued in TX
Practice address
8401 Datapoint Dr Ste 600
San Antonio, TX 78229-5907
Phone
(210) 616-7700
Fax
(210) 616-7709
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X E4210 TX
Neuroradiology Physician 2085N0700X E4210 TX
Diagnostic Radiology Physician 2085R0202X E4210 TX Primary
Diagnostic Ultrasound Physician 2085U0001X E4210 TX

Addresses

Primary practice location

8401 Datapoint Dr Ste 600
San Antonio, TX 78229-5907

Mailing address

8401 Datapoint, Suite 600
P. O. Box 29441
San Antonio, TX 78229-0441
Phone (210) 616-7796

Other identifiers 2

IdentifierTypeStateIssuer
1345209-08MedicaidTX
8L26749OtherTXMEDICARE - STRIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E4210TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Four Seasons Breast Foundation Past Accepting new patients
South Texas Radiology Group PA Diagnostic Radiology Past Accepting new patients

Organizations & group practices 2

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1508843392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 DATAPOINT, SUITE 600",
            "address_2": "P. O. BOX 29441",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782290441",
            "telephone_number": "210-616-7796",
            "fax_number": "210-616-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 DATAPOINT DR STE 600",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295907",
            "telephone_number": "210-616-7700",
            "fax_number": "210-616-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "ERNESTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "TX",
            "license": "E4210",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "TX",
            "license": "E4210",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "E4210",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "TX",
            "license": "E4210",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1345209-08",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - STRIC",
            "identifier": "8L26749",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; 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.