Organization Active NPI

Raymond Paul-Blanc, MD, PC

  • Urology Physician
  • Mansfield, MA
National Provider Identifier
1659438539
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
RAYMOND PAUL-BLANC, MD, PC
Practice address
16 Creeden St
#4
Mansfield, MA 02048-1212
Phone
(508) 339-3600
Fax
(508) 339-3831
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Authorized official

Name
Raymond Paul-Blanc, M.D.NPI 1831197748
Title
President
Phone
(508) 339-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

16 Creeden St
#4
Mansfield, MA 02048-1212

Mailing address

340 Main St
Ste. 670
Worcester, MA 01608-1604
Phone (508) 754-3566

Other identifiers 1

IdentifierTypeStateIssuer
9781901MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080318000221 MA Part B Supplier - Clinic/Group Practice 4082790977 Receives reassigned benefits from 1 practitioner
Practice locations: Norfolk, MA

National Provider Directory

National Provider Directory

Locations

16 Creeden St
#4
Mansfield, MA 02048
Phone (508) 339-3600

31 Pine St
Ste 203
Norfolk, MA 02056
Phone (508) 339-3600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5022/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1659438539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAIN ST",
            "address_2": "STE. 670",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081604",
            "telephone_number": "508-754-3566",
            "fax_number": "508-438-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CREEDEN ST",
            "address_2": "#4",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020481212",
            "telephone_number": "508-339-3600",
            "fax_number": "508-339-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND PAUL-BLANC, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "PAUL-BLANC",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-339-3600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9781901",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.