THEOPHANY ANNE CRUZAT BLANCO MD
NPI 1477135390
Student in an Organized Health Care Education/Training Program in Brooklyn, NY

Active since April 21, 2021PECOS EnrolledAccepts Medicare Assignment
4802 10TH AVE, BROOKLYN, NY 11219(718) 283-6000 Get Directions Write a Review

NPPES record last updated: April 21, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Theophany Anne Cruzat Blanco Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEOPHANY ANNE CRUZAT BLANCO MD (NPI 1477135390) is an individual student in an organized health care education/training program in Brooklyn, New York and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1477135390
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameTHEOPHANY ANNE CRUZAT BLANCOCredential: MD
Location Address4802 10TH AVEBrooklyn, NY 11219-2916
Mailing Address4802 10th AveBrooklyn, NY 11219-2916 · (718) 283-6000
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateApril 21, 2021
NPPES CertifiedMarch 27, 2021
NPI 1477135390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4802 10TH AVE, Brooklyn, NY 11219

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Theophany Anne Cruzat Blanco Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921527110
PECOS Enrollment IDI20250521000838
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Legal Medicine
4802 10TH AVE
BROOKLYN, NY 11219
Nurse Practitioner (Psychiatric/Mental Health)
4802 10TH AVE
BROOKLYN, NY 11219
Student in an Organized Health Care Education/Training Program
4802 10TH AVE
BROOKLYN, NY 11219
Student in an Organized Health Care Education/Training Program
4802 10TH AVE
BROOKLYN, NY 11219
Student in an Organized Health Care Education/Training Program
4802 10TH AVE
BROOKLYN, NY 11219
Student in an Organized Health Care Education/Training Program
4802 10TH AVE
BROOKLYN, NY 11219
Nurse Practitioner (Family)
4802 10TH AVE, PRE-TESTING
BROOKLYN, NY 11219
Internal Medicine (Infectious Disease)
4802 10TH AVE
BROOKLYN, NY 11219

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theophany Anne Blanco's NPI number?

The NPI number for Theophany Anne Blanco is 1477135390. It was assigned to this individual provider in the NPPES registry on April 21, 2021.

Where is Theophany Anne Blanco located?

Theophany Anne Blanco practices at 4802 10th Ave, Brooklyn, NY 11219. The listed phone number is (718) 283-6000.

What is Theophany Anne Blanco's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Theophany Anne Blanco enrolled in Medicare?

Yes. Theophany Anne Blanco is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Theophany Anne Blanco was last updated on April 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.