Individual provider Active NPI

Thomas Edward Blaney, DPM

  • Podiatrist
  • Downers Grove, IL
National Provider Identifier
1902823438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016003949 Issued in IL
Practice address
1501 Ogden Avenue
Downers Grove, IL 60515-2737
Phone
(630) 963-3368
Fax
(630) 963-4557
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016003949 IL Primary

Addresses

Primary practice location

1501 Ogden Avenue
Downers Grove, IL 60515-2737

Mailing address

1501 Ogden Avenue
Downers Grove, IL 60515-2737
Phone (630) 963-3368

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070409000218 IL Practitioner - Podiatry 4082718606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

515 Ogden Ave
Suite 101
Downers Grove, IL 60515-3081
Phone (630) 963-3668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016003949ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas E. Blaney, DPM, P.C. CurrentSince Oct 9, 2003 Accepting new patients

Locations

1501 Ogden Ave
Ste 101
Downers Grove, IL 60515
Phone (630) 963-3668

515 Ogden Ave
Ste 101
Downers Grove, IL 60515
Phone (630) 963-3668

1501 Ogden Ave
Downers Grove, IL 60515
Phone (630) 969-1677

Interoperability endpoints

  • Direct secure messaging: drblaney@tebdp-il.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902823438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 OGDEN AVENUE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152737",
            "telephone_number": "630-963-3368",
            "fax_number": "630-963-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 OGDEN AVENUE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152737",
            "telephone_number": "630-963-3368",
            "fax_number": "630-963-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANEY",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.