NPIMap

Individual provider Active NPI

Julieta G Tablante-Blanco, MD

  • Cytopathology Physician
  • Las Vegas, NV
National Provider Identifier
1750377495
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cytopathology PhysicianTaxonomy code 207ZC0500X
License
4301078930 Issued in MI
Practice address
7455 W Washington Ave Ste 301
Las Vegas, NV 89128-4340
Phone
(702) 732-3441
NPI assigned
Sep 27, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 24437 NV
Cytopathology Physician 207ZC0500X 4301078930 MI Primary

Addresses

Primary practice location

7455 W Washington Ave Ste 301
Las Vegas, NV 89128-4340

Mailing address

1355 River Bend Dr
Dallas, TX 75247-4915
Phone (512) 439-1600

Other identifiers 2

IdentifierTypeStateIssuer
4485240MedicaidMI
4485231MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NV, AZ3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040310000912 MI Practitioner - Pathology 5890683734 Reassigns benefits to 1 organization
I20240515004444 NV Practitioner - Pathology 5890683734 Reassigns benefits to 1 organization
I20240515004460 AZ Practitioner - Pathology 5890683734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laboratory Medicine Consultants LTDGroup PAC ID 4183617533, shared by 2 NPIs, 26 clinicians

Practice addresses (Care Compare)

7455 W Washington Ave
Las Vegas, NV 89128-4337
Phone (702) 732-3441

7455 W Washington Ave
Suite 301
Las Vegas, NV 89128-4340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.98 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301078930MIMDCytopathology Physician
24437NVMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laboratory Medicine Consultants LTD Cytopathology CurrentSince Apr 15, 2024 Accepting new patients
Laboratory Medicine Consultants LTD CurrentSince Apr 15, 2024 Accepting new patients
Michigan Pathology Specialists PC Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2003 Accepting new patients

Locations

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

File 749203
Los Angeles, CA 90074

35 Michigan St NE
Stop 56
Grand Rapids, MI 49503

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

2990 Franklin Ave SW
Grandville, MI 49418
Phone (616) 530-3344

7455 W Washington Ave
Ste 301
Las Vegas, NV 89128
Phone (702) 732-3441

3059 S Maryland Pkwy
Ste 100
Las Vegas, NV 89109
Phone (702) 732-3441

7455 W Washington Ave
Las Vegas, NV 89128
Phone (702) 425-0978

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

1355 River Bend Dr
Dallas, TX 75247
Phone (214) 237-1818

Organizations & group practices 3

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1750377495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474915",
            "telephone_number": "512-439-1600",
            "fax_number": "844-751-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7455 W WASHINGTON AVE STE 301",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891284340",
            "telephone_number": "702-732-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABLANTE-BLANCO",
        "first_name": "JULIETA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NV",
            "license": "24437",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "MI",
            "license": "4301078930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4485240",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4485231",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.