Benjamin Blake, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-02102 Issued in NU

Practice address

2600 Ottawa Rd
Neodesha, KS 66757-1897

Phone

(620) 325-2611

Fax

(620) 325-8453

NPI assigned

Jun 26, 2018

Last updated

Sep 25, 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 KS

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilson County HospitalGroup PAC ID 0042273971, 10 clinicians

Sumner County Hospital District No 1Group PAC ID 6103925268, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wilson Medical Center Hospital, Neodesha, KS, CCN 171344
• Caldwell Regional Medical Center Hospital, Caldwell, KS, CCN 171329

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Sumner County Hospital District No 1

  dba Caldwell Regional Medical Center

  • Critical Access Hospital
  • Caldwell, KS
  • NPI 1215094438
  Medicare reassignment Care Compare group
• Wilson County Hospital

  dba Wilson Medical Center Professional

  • Nurse Practitioner
  • Neodesha, KS
  • NPI 1992842942
  Medicare reassignment Care Compare group
• James M McDermott, D.O.

  • Family Medicine Physician
  • Cedar Vale, KS
  • NPI 1427079953
  Medicare reassignment
• Sumner County Hospital District No 1

  dba Caldwell Family Clinic

  • Rural Health Clinic/Center
  • Caldwell, KS
  • NPI 1881327153
  NPD
• Wilson County Hospital

  dba Independence Family Medicine

  • Rural Health Clinic/Center
  • Independence, KS
  • NPI 1003251802
  NPD
• Wilson County Hospital

  dba Neodesha Family Medicine

  • Rural Health Clinic/Center
  • Neodesha, KS
  • NPI 1639699309
  NPD
• James M McDermott DO

  • Family Medicine Physician
  • Cedar Vale, KS
  • NPI 1437276995
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sumner County Hospital District No 1

  dba Caldwell Regional Medical Center

  • Critical Access Hospital
  • Caldwell, KS
  • NPI 1215094438
  Care Compare affiliation
• Wilson County Hospital

  • Critical Access Hospital
  • Neodesha, KS
  • NPI 1669441176
  Care Compare affiliation

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1053806539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360",
            "city": "NEODESHA",
            "state": "KS",
            "postal_code": "667570360",
            "telephone_number": "620-325-2611",
            "fax_number": "620-325-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 OTTAWA RD",
            "city": "NEODESHA",
            "state": "KS",
            "postal_code": "667571897",
            "telephone_number": "620-325-2611",
            "fax_number": "620-325-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "15-02102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Hunter Barrett, M.D.
• Lloyd G Baumwart, DDS
• Ashley Gail Bemo, PA-C
• Allisan Bennett
• Bert Chronister, M.D., P.a.
• Bradley H Barrett, MD
• Cancer Center of Kansas, PA
• Kayden Anne Carter, MD
• Kira Chapman-Eberhart, PT
• Chiropractic Connection LLC

• Physician Assistant in Neodesha, KS
• Providers in Neodesha, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.
• 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.