Individual provider Active NPI

Ramon Arturo Blandino, LIC. FAMILY THERAPIS

  • Marriage & Family Therapist
  • Bayside, NY
National Provider Identifier
1790840494
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
000610-1 Issued in NY
Practice address
39-26 Clearview Expressway
2ND Floor
Bayside, NY 11361
Phone
(917) 533-0507
NPI assigned
Dec 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 000610-1 NY Primary

Addresses

Primary practice location

39-26 Clearview Expressway
2ND Floor
Bayside, NY 11361

Mailing address

39-26 Clearview Expressway
2ND Floor
Bayside, NY 11361
Phone (917) 533-0507

Other identifiers 1

IdentifierTypeStateIssuer
000610-1OtherNYLIC. FAMILY THERAPIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181207002389 NY Practitioner - Other (Non-Physician) 3779827332 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000610-1NYMDMarriage & Family Therapist
000610NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Health Plan, Inc. CurrentSince Oct 13, 2018 Accepting new patients
Urban Health Plan, Inc. CurrentSince Oct 13, 2018 Accepting new patients
Minds Together LCSW PC Past Accepting new patients

Locations

1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

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.

NPI Registry JSON

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

{
    "created_epoch": "1167004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790840494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39-26 CLEARVIEW EXPRESSWAY",
            "address_2": "2ND FLOOR",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11361",
            "telephone_number": "917-533-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39-26 CLEARVIEW EXPRESSWAY",
            "address_2": "2ND FLOOR",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11361",
            "telephone_number": "917-533-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANDINO",
        "first_name": "RAMON",
        "middle_name": "ARTURO",
        "name_prefix": "Mr.",
        "credential": "LIC. FAMILY THERAPIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "000610-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC. FAMILY THERAPIST",
            "identifier": "000610-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.