Mario Blanco, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

90265 Issued in FL

Practice address

2100 Prevatt St
Eustis, FL 32726-6130

Phone

(352) 308-8903

Fax

(352) 460-0785

NPI assigned

Mar 18, 2006

Last updated

Oct 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• American Physicians Foundation Corporation

  dba digestive disease foundation

  • Specialist
  • Jacksonville, FL
  • NPI 1922013754
  NPD
• Digestive Disease Consultants

  • Gastroenterology Physician
  • Jacksonville, FL
  • NPI 1710251921
  NPD
• Digestive Health Associates PA

  • Gastroenterology Physician
  • Ocala, FL
  • NPI 1487929550
  NPD
• Gastroenterology Specialist Inc

  • Gastroenterology Physician
  • Palm Beach Gardens, FL
  • NPI 1336355718
  NPD
• J Robin Atwell,MD PA

  • Urology Physician
  • Vero Beach, FL
  • NPI 1558557470
  NPD
• Mid-Florida Pathology LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Eustis, FL
  • NPI 1265798870
  NPD
• N.F.L. Center for Oto-HNS Facial Plastic Surgery P.a.

  dba North Florida Center for Otolaryngology

  • Otolaryngology/Facial Plastic Surgery Physician
  • St Augustine, FL
  • NPI 1851325781
  NPD
• Aams Pathology Consultants

  • Anatomic Pathology & Clinical Pathology Physician
  • Loxahatchee, FL
  • NPI 1790754356
  NPD (past)
• Florida ENT Associates, Inc.

  dba South Florida ENT Associates, Inc.

  • Otolaryngology Physician
  • West Miami, FL
  • NPI 1184625733
  NPD (past)
• Gastroenterology Specialists Inc

  • Specialist
  • Palm Beach Gardens, FL
  • NPI 1366404618
  NPD (past)

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1891754917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 GREENBRIAR BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334147157",
            "telephone_number": "561-204-5455",
            "fax_number": "561-204-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PREVATT ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266130",
            "telephone_number": "352-308-8903",
            "fax_number": "352-460-0785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2815 Greenbriar Blvd",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334147157",
            "country_code": "US",
            "telephone_number": "561-204-5455",
            "fax_number": "561-204-5455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "90265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269882000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1265798870",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Black
• Sharon I Blackman, BC-HIS,ACA
• Kari Elizabeth Blamick, AT STUDENT
• Nicole Blanch
• Robert Blanchette, M.ED.; ED.S.
• Teddy Roger Bland Jr., DMD, MS
• Joseph Brian Bodovetz
• Body Rehab & Performance LLC
• Natalie Bonds
• Shaketa Boone Lee

• Anatomic Pathology & Clinical Pathology Physician in Eustis, FL
• Providers in Eustis, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.