NPIMap

Individual provider Active NPI

Breanne M Blake, PA-C

  • Physician Assistant
  • Kittanning, PA
National Provider Identifier
1245631019
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA004127 Issued in NU
Practice address
10261 PA-85
Kittanning, PA 16201
Phone
(724) 783-7124
NPI assigned
Sep 11, 2014
Last updated
Jul 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA004127 NU Primary
Medical Physician Assistant 363AM0700X MA057085 PA

Addresses

Primary practice location

10261 PA-85
Kittanning, PA 16201

Mailing address

1 Nolte Dr
Kittanning, PA 16201-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141028002444 PA Practitioner - Physician Assistant 6507087970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

102 S St
New Bethlehem, PA 16242-1238
Phone (814) 275-2264

10261 State Route 85
Kittanning, PA 16201-8165
Phone (724) 783-7124

116 Main St
Leechburg, PA 15656-1333
Phone (724) 845-1211

260 S Jefferson St
Armstrong Primary Care Center Kittanning
Kittanning, PA 16201-2422
Phone (724) 543-5919

300 Medical Arts BLDG
Suite 300
Kittanning, PA 16201-7129
Phone (724) 545-1288

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Armstrong County Memorial Hospital CurrentSince Sep 23, 2025 Accepting new patients
Armstrong County Memorial Hospital Current Accepting new patients
New Directions Psychiatry PC Past Accepting new patients
Armstrong County Memorial Hospital Past Accepting new patients

Locations

1 Nolte Dr
Kittanning, PA 16201
Phone (724) 543-8109

Interoperability endpoints

  • Direct secure messaging: breanne.blake@1ah.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1245631019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NOLTE DR",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10261 PA-85",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "16201",
            "telephone_number": "724-783-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "BREANNE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "OA004127",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057085",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kittanning, PA

Sources for this page

Verify at the official NPI Registry.