NPIMap

Individual provider Active NPI

Michael Scott Blanc, M.D.

  • Interventional Cardiology Physician
  • San Angelo, TX
National Provider Identifier
1932139953
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
L3583 Issued in TX
Practice address
3350 Executive Dr
Suite 100
San Angelo, TX 76904-6878
Phone
(325) 245-4501
Fax
(325) 245-4008
NPI assigned
Jul 4, 2006
Last updated
Mar 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X L3583 TX Primary

Addresses

Primary practice location

3350 Executive Dr
Suite 100
San Angelo, TX 76904-6878

Mailing address

125 S Park Dr
Ste H
Brownwood, TX 76801-5952
Phone (325) 641-8648

Other identifiers 4

IdentifierTypeStateIssuer
151420001MedicaidTX
151420003MedicaidTX
8U8633OtherTXBLUE CROSS
151420002MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070305000475 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5496762270 Reassigns benefits to 1 organization
I20210217000616 NH Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5496762270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hendrick Provider NetworkGroup PAC ID 9739162181, 234 clinicians

Practice addresses (Care Compare)

125 S Park Dr
Suite H
Brownwood, TX 76801-5952
Phone (325) 641-0400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting65
Pacemaker insertion or repair36
Varicose vein removal22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Feb 8, 2021 Accepting new patients
Hendrick Provider Network CurrentSince Apr 1, 2021 Accepting new patients
Hendrick Provider Network Interventional Cardiology CurrentSince Apr 1, 2021 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Feb 8, 2021 Accepting new patients
Regional Employee Assistance Program Inc PastSince Nov 1, 2006 Accepting new patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients

Locations

19 Old Rollinsford Rd
Bldg B
Dover, NH 03820
Phone (603) 516-4265

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

1904 Pine St
Ste 4A
Abilene, TX 79601
Phone (325) 437-4020

125 S Park Dr
Ste H
Brownwood, TX 76801
Phone (325) 641-8648

300 E Commerce St
Brownwood, TX 76801
Phone (325) 510-3400

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1932139953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S PARK DR",
            "address_2": "STE H",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768015952",
            "telephone_number": "325-641-8648",
            "fax_number": "325-643-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 EXECUTIVE DR",
            "address_2": "SUITE 100",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046878",
            "telephone_number": "325-245-4501",
            "fax_number": "325-245-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANC",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "L3583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151420001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151420003",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8U8633",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151420002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.