Brittany Roberts-Blake, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

028727-01 Issued in NY

Practice address

1110 Granville Payne Ave
Brooklyn, NY 11207-9003

Phone

(718) 691-6366

NPI assigned

Nov 29, 2020

Last updated

Apr 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 NY

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forest Hills Dermatology Group PLLCGroup PAC ID 6608037320, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Forest Hills Dermatology Group PLLC

  • Dermatology Physician
  • Kew Gardens, NY
  • NPI 1225309586
  Medicare reassignment Care Compare group
• Divinity Medical Services PLLC

  dba AFC Urgent Care Yorktown

  • Urgent Care Clinic/Center
  • Yorktown Heights, NY
  • NPI 1497159560
  Medicare reassignment

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

{
    "created_epoch": "1606608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1215531389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 GRANVILLE PAYNE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112079003",
            "telephone_number": "718-691-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 GRANVILLE PAYNE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112079003",
            "telephone_number": "718-691-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS-BLAKE",
        "first_name": "BRITTANY",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-29",
        "last_updated": "2023-04-17",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028727-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Scott Roberti, DDS
• Roberto Clemente Center
• Maria Felice Roberto, D.O.
• Janna Mirakle Roberts Gervais
• Roberts Medical PC
• Adella Stacy Roberts
• Alicia Angella Roberts, RN
• Amelia D0Ris Roberts, RN
• Anastasia Roberts, TEACHER
• Anthony Roberts, ADVANCE CASAC

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.