Michael Jack Blake, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

20757 Issued in CO

Practice address

390 S Wilcox St Ste B
Castle Rock, CO 80104-1951

Phone

(303) 839-8068

Fax

(303) 835-3597

NPI assigned

Sep 3, 2024

Sex

Male

Sole proprietor

No

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.

• Panorama Orthopedics and Spine Center PC

  • Orthopaedic Surgery Physician
  • Golden, CO
  • NPI 1295787950

  CO

  Medicare reassignment Care Compare group NPD
• Elite Physical Therapy, LLC

  • Physical Therapist
  • Warwick, RI
  • NPI 1225123565

  MA, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Peak Performance Physical Therapy, PLC

  • Physical Therapist
  • Lansing, MI
  • NPI 1134428642

  MI, Physical Therapist

  Medicare reassignment NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638

  WA

  Medicare reassignment
• Panorama Orthopedics and Spine Center PC

  • Customized Equipment (DME)
  • Golden, CO
  • NPI 1992399273
  Care Compare group
• Panorama Orthopedics & Spine Center, PC

  • Physical Therapy Clinic/Center
  • Colorado Springs, CO
  • NPI 1194390518
  NPD
• Panorama Orthopedics & Spine Center, PC

  • Physical Therapy Clinic/Center
  • Aurora, CO
  • NPI 1841916186
  NPD
• Multicare Health System

  • Family Medicine Physician
  • Covington, WA
  • NPI 1093768657

  Physical Therapist

  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Ryan and Monica Wohlfert, PC

  • Chiropractor
  • Lansing, MI
  • NPI 1952478125
  NPD

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Multicare Health System 2,312 clinicians

Panorama Orthopedics and Spine Center PC 316 clinicians

Elite Physical Therapy LLC 73 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MI, MA, CO, WA4 enrollments

Enrollment records 4

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 5, 2025.

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1295560100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 S WILCOX ST STE B",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041951",
            "telephone_number": "303-839-8068",
            "fax_number": "303-835-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 S WILCOX ST STE B",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041951",
            "telephone_number": "303-839-8068",
            "fax_number": "303-835-3597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7402 Westshire Dr",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489178988",
            "country_code": "US",
            "telephone_number": "517-853-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "MICHAEL",
        "middle_name": "JACK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-03",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303478",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "20757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Adelle Bishop, LCSW
• Bithell Family Chiropractic P.C.
• Thomas L Bithell, D.C.
• Ariana Bryn Blaher, D.C
• Gordon Talmadge Blair III, DPT
• David Blankenship
• Jane Blankenship
• Aaron Robert Block, M.D., M.P.H.
• Elizabeth Ruth Blom, MPT
• Judy Ferer Bloomberg, MD

• All providers in Castle Rock, CO
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.