Individual provider Active NPI

Lisa Marie Mangino-Blanchard, CRNP

  • Acute Care Nurse Practitioner
  • Pomona, NJ
National Provider Identifier
1811273980
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ01034600 Issued in NJ
Practice address
65 W Jimmie Leeds Rd FL 1
Pomona, NJ 08240-9102
Phone
(609) 748-7089
Fax
(609) 652-3460
NPI assigned
Nov 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP007067 PA
Acute Care Nurse Practitioner 363LA2100X 26NJ01034600 NJ Primary

Addresses

Primary practice location

65 W Jimmie Leeds Rd FL 1
Pomona, NJ 08240-9102

Mailing address

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-9595

Other practice location 1

51 N 39th St
Philadelphia, PA 19104-2640
Phone (215) 662-9595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120113000563 PA Practitioner - Nurse Practitioner 0446427439 Reassigns benefits to 2 organizations
I20250513000034 NJ Practitioner - Nurse Practitioner 0446427439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-2050

51 N 39TH St HVP 2ND FL
Div of Cardiology
Philadelphia, PA 19104-2640
Phone (215) 662-9010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Mar 13, 2017 Accepting new patients
Clinical Health Care Associates of New Jersey PC CurrentSince Feb 28, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Feb 28, 2025 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Atlanticare Regional Medical Center Acute Care Past Accepting new patients
Atlanticare Physician Group Past Accepting new patients

Locations

211 S Main St
Ste 205
Cape May Court House, NJ 08210
Phone (609) 463-0800

1865 Route 70 E
Ste 260
Cherry Hill, NJ 08003
Phone (215) 662-9595

3400 Spruce St
Fl 6
Philadelphia, PA 19104
Phone (215) 615-0800

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

51 N 39th St
Ste 2A
Philadelphia, PA 19104
Phone (215) 662-9595

3400 Spruce St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-2050

Organizations & group practices 9

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1811273980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W JIMMIE LEEDS RD FL 1",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "082409102",
            "telephone_number": "609-748-7089",
            "fax_number": "609-652-3460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 N 39th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191042640",
            "country_code": "US",
            "telephone_number": "215-662-9595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGINO-BLANCHARD",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP007067",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ01034600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NJ

Sources for this page

Verify at the official NPI Registry.