Active NPI
Marcela Zebede Blank, MD
- Internal Medicine Physician
- Warwick, RI
National Provider Identifier
1952490732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD10179
- Practice address
- 455 Toll Gate Road
Warwick, RI 02886 - Phone
- (401) 737-7010
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD10179 | RI | Primary |
Addresses
Primary practice location
455 Toll Gate Road
Warwick, RI 02886
Mailing address
28 Lincoln Avenue
Providence, RI 02906-5708
Phone (401) 225-7522
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9020925 | Medicaid | RI | |
| 0000021209 | Other | RI | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952490732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 LINCOLN AVENUE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029065708",
"telephone_number": "401-225-7522",
"fax_number": "401-732-1592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 TOLL GATE ROAD",
"city": "WARWICK",
"state": "RI",
"postal_code": "02886",
"telephone_number": "401-737-7010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZEBEDE BLANK",
"first_name": "MARCELA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "MD10179",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9020925",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0000021209",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.