Individual provider Active NPI

Steven Blake, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1235224718
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0058519 Issued in FL
Practice address
3625 University Blvd
Jacksonville, FL 32216
Phone
(904) 399-6811
Fax
(904) 346-0113
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0058519 FL Primary

Addresses

Primary practice location

3625 University Blvd
Jacksonville, FL 32216

Mailing address

PO Box 860554
Orlando, FL 32886
Phone (904) 346-3606

Other identifiers 1

IdentifierTypeStateIssuer
11460OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20100907000883 FL Practitioner - Internal MedicinePractitioner - Emergency Medicine 8224152640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 276-8500

Hospital & facility affiliations

  • HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0058519FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Emergency Services LLC CurrentSince Jan 1, 2016 Accepting new patients
Florida Em-I Medical Services, PA Past Accepting new patients
Florida Em-I Medical Services, PA Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients

Locations

6201 N Suncoast Blvd
Crystal River, FL 34428
Phone (352) 527-0671

11850 Atlantic Blvd
Jacksonville, FL 32225
Phone (904) 702-1330

6477 103rd St
Jacksonville, FL 32210
Phone (904) 639-8517

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

23186 Blue Star Hwy
Quincy, FL 32351
Phone (850) 875-5977

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1235224718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860554",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32886",
            "telephone_number": "904-346-3606",
            "fax_number": "904-346-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-399-6811",
            "fax_number": "904-346-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "STEVEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0058519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11460",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.