Organization Active NPI

Jessica Blanco MD PC

Doing business as Desert Foothills Family Medicine

  • Family Medicine Physician
  • Chandler, AZ
National Provider Identifier
1669642401
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JESSICA BLANCO MD PC
Doing business as
Desert Foothills Family Medicine
Practice address
5505 W Chandler Blvd
Ste.#B-13
Chandler, AZ 85226-3683
Phone
(480) 361-4780
Fax
(480) 361-4781
NPI assigned
Mar 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Jessica Blanco, MDNPI 1467446377
Title
Owner
Phone
(480) 361-4780

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

5505 W Chandler Blvd
Ste.#B-13
Chandler, AZ 85226-3683

Mailing address

5505 W Chandler Blvd
Ste.#B-13
Chandler, AZ 85226-3683
Phone (480) 361-4780

Other identifiers 1

IdentifierTypeStateIssuer
764284MedicaidAZ

Other names 1

  • Desert Foothills Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110115000085 AZ Part B Supplier - Clinic/Group Practice 1658356324 Receives reassigned benefits from 2 practitioners
Practice locations: Chandler, AZ

National Provider Directory

National Provider Directory

Locations

5505 W Chandler Blvd
Ste 13
Chandler, AZ 85226
Phone (480) 361-4780

5505 W Chandler Blvd
Ste B13
Chandler, AZ 85226
Phone (480) 361-4780

Practitioners & affiliated clinicians

Practitioners 6

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": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1669642401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 W CHANDLER BLVD",
            "address_2": "STE.#B-13",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852263683",
            "telephone_number": "480-361-4780",
            "fax_number": "480-361-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 W CHANDLER BLVD",
            "address_2": "STE.#B-13",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852263683",
            "telephone_number": "480-361-4780",
            "fax_number": "480-361-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA BLANCO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "BLANCO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-361-4780",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764284",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Foothills Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.