Brian J Blake, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

A106986 Issued in CA

Practice address

4760 Belpar St NW
Canton, OH 44718-3603

Phone

(330) 492-9200

Fax

(330) 492-5454

NPI assigned

Sep 20, 2008

Last updated

Mar 18, 2011By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Orthopedic Surgery

Education

Ohio State University College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthounited, Inc.Group PAC ID 9032197868, 89 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aultman Hospital Hospital, Canton, OH, CCN 360084
• Mercy Medical Center Hospital, Canton, OH, CCN 360070

Merit-based Incentive Payment System (MIPS)

Final score

80.13 of 100Reported as group

Quality

74.6

Promoting interoperability

70

Improvement activities

40

Cost

84.16

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bblake@omni.medentdirect.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.

• Orthounited, Inc.

  • Orthopaedic Surgery Physician
  • North Canton, OH
  • NPI 1649236142
  Medicare reassignment Care Compare group NPD
• Orthounited, Inc.

  • Orthopaedic Surgery Physician
  • Akron, OH
  • NPI 1174357651
  NPD

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

• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation
• Cleveland Clinic Mercy Hospital

  dba Mercy Medical Center

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Care Compare affiliation

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

{
    "created_epoch": "1221868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1124278668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 BELPAR ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183603",
            "telephone_number": "330-492-9200",
            "fax_number": "330-492-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 BELPAR ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183603",
            "telephone_number": "330-492-9200",
            "fax_number": "330-492-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-20",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A106986",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35095075",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Blackwell
• Donna Fall Blackwell, BSN, RNC, NNP
• Lisa Blackwell
• Troy Blagrave, M.D.
• Michele Pollak Blaho, CRNA
• Brittany Ann Blake, DPT
• Lynn Blakeney
• Bob Blamo
• March Siah Blamo
• Daija Blanchard

• Sports Medicine (Orthopaedic Surgery) Physician in Canton, OH
• Providers in Canton, OH by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.