Blake M Barbera, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

09411 Issued in LA

Practice address

1410 Tiger Dr Ste 101
Thibodaux, LA 70301-4337

Phone

(985) 665-6672

NPI assigned

Feb 4, 2012

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Evolve Rehab and Recovery

  • Physical Therapy Clinic/Center
  • Thibodaux, LA
  • NPI 1396542148
  NPD Authorized official
• Genesis Physical Therapy and Wellness, LLC

  • Physical Therapist
  • Thibodaux, LA
  • NPI 1821553397
  NPD (past)

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

{
    "created_epoch": "1328313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1285906396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 LAKE HOWARD AVE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703011627",
            "telephone_number": "985-665-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 TIGER DR STE 101",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014337",
            "telephone_number": "985-665-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBERA",
        "first_name": "BLAKE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-04",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "27121",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "09411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Lance Babin, M.D.
• Sheila Baillio, RN
• Laura Marie Balcerak, PSS
• Jolissa Johnson Baloney
• Desiree Banks
• Bariatric & Advanced Surgical
• Pamela A Barker, RN
• James Barletta
• Jessica Barquet
• J Chris Barrilleaux, LCSW

• Physical Therapist in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.