Active NPI
Douglas Blake, MD
- Anesthesiology Physician
- Providence, RI
National Provider Identifier
1104883123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- RI8815
- Practice address
- 591 Eddy St
Dept of Anesthesia
Providence, RI 02903-4922 - Phone
- (401) 444-2284
- Fax
- (401) 444-5083
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | RI8815 | RI | Primary |
Addresses
Primary practice location
591 Eddy St
Dept of Anesthesia
Providence, RI 02903-4922
Mailing address
690 Canton St
Ste 325
Westwood, MA 02090-2324
Phone (781) 407-7713
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DB12516 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RI8815 | RI | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104883123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 CANTON ST",
"address_2": "STE 325",
"city": "WESTWOOD",
"state": "MA",
"postal_code": "020902324",
"telephone_number": "781-407-7713",
"fax_number": "781-407-0998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "591 EDDY ST",
"address_2": "DEPT OF ANESTHESIA",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034922",
"telephone_number": "401-444-2284",
"fax_number": "401-444-5083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "DOUGLAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "RI",
"license": "RI8815",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DB12516",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.