Individual provider Active NPI

David Paul Blake, MD, MPH

Surgery Physician
Falls Church, VA

National Provider Identifier

1063484210

Registry record updated Jun 21, 2022

On this page

Key facts
NPPES NPI Registry
Medicare participation
Care Compare profile
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Falls Church, VA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Surgery PhysicianTaxonomy code 208600000X
License: 0101241616 Issued in VA
Practice address: 3300 Gallows Rd
Falls Church, VA 22042-3307
Phone: (703) 531-2246
Fax: (703) 237-7895
NPI assigned: Feb 2, 2006
Sex: Male
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 8

Specialty (taxonomy)	Code	License	State	Primary
Surgical Critical Care Physician	2086S0102X	35.093895	OH
Surgery Physician	208600000X	61499	CT
Surgical Critical Care Physician	2086S0102X	61499	CT
Surgical Critical Care Physician	2086S0102X	0101241616	VA
Trauma Surgery Physician	2086S0127X	0101241616	VA
Trauma Surgery Physician	2086S0127X	35.093895	OH
Trauma Surgery Physician	2086S0127X	61499	CT
Surgery Physician	208600000X	0101241616	VA	Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3307

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

6565 Arlington Blvd Ste 500
Falls Church, VA 22042-3018
Phone (703) 531-2246

Other practice location 2

825 Fairfax Ave
Sixth Floor
Norfolk, VA 23507-1914
Phone (757) 446-8950

Other practice location 3

80 Seymour St
Hartford Hospital Surgery Dept
Hartford, CT 06102
Phone (860) 972-4189

Other practice location 4

85 Seymour St Ste 415
Hartford, CT 06106-5523
Phone (860) 246-2071

Other identifiers 12

Identifier	Type	State	Issuer
488414	Other	VA	ANTHEM BC/BS
PAR	Other	VA	MULTIPLAN
PAR	Other	VA	CIGNA
1063484210	Other	VA	UNITED HEALTHCARE
1063484210	Other	VA	COVENTRY HEALTH NETWORK
PAR	Other	VA	CORVEL
10106541	Other	VA	OPTIMA HEALTH
1063484210	Medicaid	VA
PAR	Other	VA	USA MANAGED CARE
1063484210	Medicaid	NC
PAR	Other	VA	VIRGINIA HEALTH NETWORK
PAR	Other	VA	AETNA

Electronic endpoints 1

Type	Endpoint	Use	Affiliation
Direct Messaging Address	dblake669122@soc.inova.org	Health Information Exchange (HIE)	Inova Health Care Services

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment

Enrolled in DC

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 1

Enrollment ID	State	Provider type	PAC ID	Details
I20200124000837	DC	Practitioner - General Surgery	4082769393	Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score: 83.36 of 100Reported as group
Quality: 73.03
Promoting interoperability: 100
Improvement activities: 40
Cost: 71.49

National Provider Directory

Medicare enrollment (NPD): Enrolled
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
35.093895	OH	MD	Surgical Critical Care Physician

Interoperability endpoints

Direct secure messaging: dblake43699@connecticutchildrens.direct-ci.com
Direct secure messaging: dblake669122@soc.inova.org

Organizations & group practices 1

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.

Inova Health Care Services
- Internal Medicine Physician
- Falls Church, VA
- NPI 1952320061
DC
Medicare reassignment

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1063484210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-531-2246",
            "fax_number": "703-237-7895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 Arlington Blvd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423018",
            "country_code": "US",
            "telephone_number": "703-531-2246",
            "fax_number": "703-237-7895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 Fairfax Ave",
            "address_2": "Sixth Floor",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071914",
            "country_code": "US",
            "telephone_number": "757-446-8950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Seymour St",
            "address_2": "Hartford Hospital Surgery Dept",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "06102",
            "country_code": "US",
            "telephone_number": "860-972-4189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 Seymour St Ste 415",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061065523",
            "country_code": "US",
            "telephone_number": "860-246-2071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "OH",
            "license": "35.093895",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "61499",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CT",
            "license": "61499",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "VA",
            "license": "0101241616",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "VA",
            "license": "0101241616",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "OH",
            "license": "35.093895",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CT",
            "license": "61499",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101241616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "488414",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1063484210",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH NETWORK",
            "identifier": "1063484210",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH",
            "identifier": "10106541",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063484210",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063484210",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "PAR",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dblake669122@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3300 Gallows Rd",
            "city": "Falls Church",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220423307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.