Blake Robert Erickson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

306115 Issued in NY

Practice address

680 W End Ave Ste 1a
New York, NY 10025-6815

Phone

(646) 355-8444

Fax

(972) 947-5176

NPI assigned

Apr 12, 2019

Last updated

Jul 3, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1225591464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 W END AVE STE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256815",
            "telephone_number": "646-355-8444",
            "fax_number": "972-947-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 W END AVE STE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256815",
            "telephone_number": "646-355-8444",
            "fax_number": "972-947-5176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100321007",
            "country_code": "US",
            "telephone_number": "847-772-3403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "BLAKE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "306115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Ann Ericksen, LMSW
• Laura Erickson-Schroth, MD
• Aimee A Erickson, FNP, RN, BSN
• Alma Erickson
• Berit Erickson, FNP
• Candace Jean Erickson, MD
• Dana P Erickson, DPT
• Erin Nicole Erickson, D.D.S.
• Francesca Susan Erickson, CMT, LVN
• Jessica Erickson, LMSW

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.