Individual provider Active NPI

Emmeline Dunque Blankenbicker, M.D

  • Internal Medicine Physician
  • Winter Park, FL
National Provider Identifier
1780658989
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME71155 Issued in FL
Practice address
1950 Lee Rd
Suite 105
Winter Park, FL 32789
Phone
(407) 647-2346
Fax
(407) 647-5431
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2012

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 ME71155 FL Primary

Addresses

Primary practice location

1950 Lee Rd
Suite 105
Winter Park, FL 32789

Mailing address

102 W. Pineloch Ave
Suite 23
Orlando, FL 32806-6100
Phone (407) 481-7174

Other identifiers 2

IdentifierTypeStateIssuer
32227OtherFLBCBS
252586100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140502001575 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5799760765

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME71155FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Medical Center, PL Internal Medicine PastSince Jun 7, 2004 Accepting new patients
Neil Coskun, MD,PA Internal Medicine Past Accepting new patients
Healthcare America Medical Group, Inc. Internal Medicine Past Accepting new patients
Center for Medicine Inc Internal Medicine Past Accepting new patients
Central Florida Inpatient Medicine LLC Internal Medicine PastSince Jul 21, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17286/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332720000000",
    "number": "1780658989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W. PINELOCH AVE",
            "address_2": "SUITE 23",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066100",
            "telephone_number": "407-481-7174",
            "fax_number": "407-481-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 LEE RD",
            "address_2": "SUITE 105",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32789",
            "telephone_number": "407-647-2346",
            "fax_number": "407-647-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNQUE BLANKENBICKER",
        "first_name": "EMMELINE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2012-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME71155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "32227",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252586100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.