Kenneth D Blake, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

41202 Issued in CO

Practice address

10103 Ridgegate Pkwy
Suite 208
Lone Tree, CO 80124-5520

Phone

(303) 535-5350

Fax

(303) 535-5353

NPI assigned

Sep 21, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Colorectal Surgery (Proctology)Also: General Surgery

Education

Johns Hopkins University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Surgone PCGroup PAC ID 9032002985, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sky Ridge Medical Center Hospital, Lone Tree, CO, CCN 060112
• AdventHealth Littleton Hospital, Littleton, CO, CCN 060113

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenneth.blake@surgone.directbygreenway.com

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.

• Surgone, PC

  • Surgery Physician
  • Greenwood Village, CO
  • NPI 1225143407

  Colon & Rectal Surgery

  Medicare reassignment Care Compare group NPD
• Surgone, PC

  • Surgery Physician
  • Greenwood Village, CO
  • NPI 1841747128
  NPD

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

• HCA Healthone LLC

  • General Acute Care Hospital
  • Lone Tree, CO
  • NPI 1659325629
  Care Compare affiliation
• Portercare Adventist Health System

  • Emergency Care Clinic/Center
  • Littleton, CO
  • NPI 1548800154

  Hospital

  Care Compare affiliation
• Portercare Adventist Health System

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1689688988
  Care Compare affiliation
• Portercare Adventist Health System

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1720628332
  Care Compare affiliation

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1174622070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8490 E CRESCENT PKWY STE 380",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112815",
            "telephone_number": "303-957-1310",
            "fax_number": "303-761-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10103 RIDGEGATE PKWY",
            "address_2": "SUITE 208",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245520",
            "telephone_number": "303-535-5350",
            "fax_number": "303-535-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "KENNETH",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CO",
            "license": "41202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04305876",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenneth.blake@surgone.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10103 Ridgegate Pkwy",
            "address_2": "Suite 208",
            "city": "Lone Tree",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801245520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Big Life Integrative Health
• Cecilia Suong Billings, OD
• Lindsey Binkley, RN
• Kimberly G Black, M.D.
• Logan Blackney, DO
• Mary Blakeley, DDS
• James M Blatchford, R.PSG.T , CRT
• Ellen R Blatt, M.D.
• Christopher K. Blicharski, M.D.
• Geoffrey Allan Block, MD

• Colon & Rectal Surgery Physician in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Colon & Rectal Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.