Emily Elisabeth Blake, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Bluffdale, UT
NPI 1235635848 · NPPES record last updated Jun 16, 2022
Key facts
- NPI
- 1235635848
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 12872798-1205 (UT)
- Practice address
- 13825 S Redwood Rd Ste 200
Bluffdale, UT 84065-5255 - Phone
- (801) 569-2626
- NPI assigned
- Apr 3, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Indiana University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- South Valley Women'S Health Care PC
Practice addresses (Care Compare)
13825 S Redwood Rd
Suite 200
Bluffdale, UT 84065-5255
Phone (801) 569-2626
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220803001788 | UT | Practitioner - Obstetrics/Gynecology | 6901153246 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12872798-1205 | UT | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Valley Women'S Health Care, PC | Current |
Accepting new patients |
Locations
13825 S Redwood Rd
Ste 200
Bluffdale, UT 84065
Phone (801) 569-2626
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | 12872798-1205 | UT | Yes |
Addresses
Primary practice location
13825 S Redwood Rd Ste 200
Bluffdale, UT 84065-5255
Mailing address
8414 Naab Rd Ste 210
Indianapolis, IN 46260-1972
Phone (317) 338-7510
Other providers in Bluffdale, UT
- Awakening Behavioral Health, LLC
- David M Babcock
- Asenath Barlow
- Jenni P. Bell
- Better Humans Therapy
- Bluffdale City Corp
- Bluffdale Dental
- Chelsea Siobhan Boushka
- Jennifer Bowman
- Tara Celine Byrne
All providers in Bluffdale, UT · Obstetrics & Gynecology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.