Blake Michael Rowe, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085009520 Issued in IL

Practice address

1425 N Hunt Club Rd
Ste 100
Gurnee, IL 60031-2632

Phone

(847) 548-2200

Fax

(847) 548-2865

NPI assigned

Oct 23, 2021

Last updated

Mar 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BIGDAA/Endpoint/BIGDAA
• Direct secure messaging: blake.rowe@phcs.eclinicaldirectplus.com

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.

• Provida Health Center SC

  dba Provida Family Medicine

  • Family Medicine Physician
  • Gurnee, IL
  • NPI 1881890333
  Medicare reassignment

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

{
    "created_epoch": "1634947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1053075325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 NORTH HUNT CLUB ROAD",
            "address_2": "STE 100",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312632",
            "telephone_number": "847-548-2200",
            "fax_number": "847-548-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N HUNT CLUB RD",
            "address_2": "STE 100",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312632",
            "telephone_number": "847-548-2200",
            "fax_number": "847-548-2865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWE",
        "first_name": "BLAKE",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-23",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosy Enterprises
• Rotating Gamma System Institute LLC
• Gehovell Rounds, PMHNP
• Roundys Supermarkets Inc (Mariano's Pharmacy)
• Jaclyn Rovner, CRC, LCPC
• Michelle Ruano, MD
• Ruby America, Inc. (Lakes Medical Supplies)
• Jessica Ruff, NCC, LPC
• Tami Ruffner, PT
• Bradley C. Rule, D.D.S.

• Physician Assistant in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.