NPIMap

Individual provider Active NPI

Benjamin Ira Blank, D.O.

  • Family Medicine Physician
  • Glendora, NJ
National Provider Identifier
1891786455
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB06092600 Issued in NJ
Practice address
1300 Black Horse Pike
Glendora, NJ 08029-1308
Phone
(856) 939-2828
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB06092600 NJ Primary

Addresses

Primary practice location

1300 Black Horse Pike
Glendora, NJ 08029-1308

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300

Other identifiers 1

IdentifierTypeStateIssuer
7016905MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613000722 NJ Practitioner - Family Practice 4981648854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

1300 Black Horse Pike
Glendora, NJ 08029-1308
Phone (856) 939-2828

132 Grove St
Suite a
Haddonfield, NJ 08033-1224
Phone (856) 354-2211

Hospital & facility affiliations

  • Holy Redeemer Home Care NJ South Home health agency, Runnemede, NJ, CCN 317025
  • Virtua Home Care at West Jersey Home health agency, Marlton, NJ, CCN 317071
  • Bayada Home Health Care, Inc Home health agency, Pennsauken, NJ, CCN 317065
  • Jefferson Health at Home by Bayada Home health agency, Voorhees, NJ, CCN 317073
  • Bayada at Inspira, Home Health and Hospice Home health agency, Millville, NJ, CCN 317089
  • Samaritan Healthcare and Hospice Hospice, Mount Laurel, NJ, CCN 311504
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB06092600NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare , LLC CurrentSince Oct 1, 2012 Accepting new patients
Advocare, LLC Family Medicine CurrentSince Oct 1, 2012 Accepting new patients
M.K. Dovnarsky,M.D.,P.C. Past Accepting new patients
Advocare, LLC Past Accepting new patients

Locations

1300 Black Horse Pike
Glendora, NJ 08029
Phone (856) 939-2828

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

25 Lindsley Dr
Ste 205
Morristown, NJ 07960
Phone (973) 993-8777

Interoperability endpoints

  • Direct secure messaging: benjamin.blank@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 11

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1891786455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BLACK HORSE PIKE",
            "city": "GLENDORA",
            "state": "NJ",
            "postal_code": "080291308",
            "telephone_number": "856-939-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "BENJAMIN",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB06092600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7016905",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, NJ

Sources for this page

Verify at the official NPI Registry.