Individual provider Active NPI

Joanna Concepcion Blanco, M.D.

  • Internal Medicine Physician
  • Harrington Park, NJ
National Provider Identifier
1588018816
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA10905800 Issued in NJ
Practice address
24 Elm St
Harrington Park, NJ 07640-1902
Phone
(201) 784-0123
NPI assigned
Apr 23, 2016
Last updated
Feb 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA10905800 NJ Primary

Addresses

Primary practice location

24 Elm St
Harrington Park, NJ 07640-1902

Mailing address

24 Elm St
Harrington Park, NJ 07640-1902
Phone (201) 784-0123

Other practice location 1

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 493-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201007000071 NJ Practitioner - Internal Medicine 1658790951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

1 N Washington Ave
Bergenfield, NJ 07621-2125
Phone (201) 568-0493

1555 Ctr Ave
Fort Lee, NJ 07024-4612
Phone (201) 510-0200

24 Elm St
Harrington Park, NJ 07640-1902
Phone (201) 451-1601

274 County Rd
Tenafly, NJ 07670-1040
Phone (201) 568-0493

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC Internal Medicine CurrentSince Oct 1, 2020 Accepting new patients
Englewood Hospital and Medical Center Past Accepting new patients

Locations

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

24 Elm St
Harrington Pk, NJ 07640
Phone (201) 784-0123

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1461369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1588018816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ELM ST",
            "city": "HARRINGTON PARK",
            "state": "NJ",
            "postal_code": "076401902",
            "telephone_number": "201-784-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 ELM ST",
            "city": "HARRINGTON PARK",
            "state": "NJ",
            "postal_code": "076401902",
            "telephone_number": "201-784-0123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Woods Rd",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "105951530",
            "country_code": "US",
            "telephone_number": "914-493-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "JOANNA",
        "middle_name": "CONCEPCION",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-23",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10905800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrington Park, NJ

Sources for this page

Verify at the official NPI Registry.