Blanca Ivelisse Osorio, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD 206513 Issued in LA

Practice address

105 Jefferson St
Natchitoches, LA 71457-4350

Phone

(318) 357-2071

Fax

(318) 521-8031

NPI assigned

Dec 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Dr. Blanca I Osorio Candelaria Other name

Medicare fee-for-service enrollment

Enrolled in LA, CO, NY, FL4 enrollments

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 4

Specialty

Psychiatry

Education

University of Puerto Rico School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blanca.osorio.1@29100.direct.athenahealth.com

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.

• MCCD FL Psychiatry Services PA

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  CO, FL, LA, Psychiatry

  Medicare reassignment Care Compare group NPD
• David Raines Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Shreveport, LA
  • NPI 1215933254

  LA

  Medicare reassignment NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428

  General Practice, LA

  Medicare reassignment NPD
• Outpatient Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Natchitoches, LA
  • NPI 1871523266

  LA

  Medicare reassignment NPD
• MCCD Psychiatry Services PLLC

  • Psychiatry Physician
  • New York, NY
  • NPI 1033750823

  NY, Psychiatry

  Medicare reassignment NPD
• Ochsner Clinic LLC

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1649719121

  General Practice

  NPD
• Outpatient Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tallulah, LA
  • NPI 1750311064
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609545600000",
    "number": "1962566166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 JEFFERSON ST",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714574350",
            "telephone_number": "318-357-2071",
            "fax_number": "318-521-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 JEFFERSON ST",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714574350",
            "telephone_number": "318-357-2071",
            "fax_number": "318-521-8031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Burma Ave",
            "address_purpose": "LOCATION",
            "city": "Gillette",
            "state": "WY",
            "postal_code": "827163426",
            "country_code": "US",
            "telephone_number": "307-688-5000",
            "fax_number": "307-688-5015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSORIO",
        "first_name": "BLANCA",
        "middle_name": "IVELISSE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2021-01-02",
        "certification_date": "2021-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WY",
            "license": "9490A",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "LA",
            "license": "MD 206513",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WY",
            "license": "TL2329",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "HI",
            "license": "13847",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "MD 206513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "361581YJR4",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234404",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLANCA",
            "last_name": "OSORIO CANDELARIA",
            "middle_name": "I",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Outpatient Medical Center, Inc.
• Outpatient Medical Center, Inc.
• Outpatient Medical Center, Inc.

• All providers in Natchitoches, LA
• Psychiatry Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2021; 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.