NPIMap

Individual provider Active NPI

Deidre Blake, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Ithaca, NY
National Provider Identifier
1336157015
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
256896 Issued in NY
Practice address
16 Brentwood Dr
Suite a
Ithaca, NY 14850-1863
Phone
(607) 272-7000
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 256896 NY Primary

Addresses

Primary practice location

16 Brentwood Dr
Suite a
Ithaca, NY 14850-1863

Mailing address

16 Brentwood Dr
Suite a
Ithaca, NY 14850-1863
Phone (607) 272-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20131203000260 NY Practitioner - Orthopedic Surgery 6103096870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cayuga Medical Associates PCGroup PAC ID 6709897960, 278 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4296

16 Brentwood Dr
Ithaca, NY 14850-1863
Phone (607) 277-2179

310 Taughannock Blvd
Suite 4
Ithaca, NY 14850-3251
Phone (607) 269-0100

Hospital & facility affiliations

  • VNS Ithaca Tompkins Co Chha Home health agency, Ithaca, NY, CCN 337212
  • Guthrie Home Health Home health agency, Cortland, NY, CCN 337449
  • Centerwell Home Health Home health agency, Liverpool, NY, CCN 337255
  • Centerwell Home Health Home health agency, Corning, NY, CCN 337292
  • HCR Home Care Home health agency, East Syracuse, NY, CCN 337119
  • Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307
  • Guthrie Cortland Regional Medical Center Hospital, Cortland, NY, CCN 330175

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement146
Knee replacement199
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256896NYMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Medical Associates, PC CurrentSince Nov 1, 2013 Accepting new patients
Fort Pierce Orthopaedics LLC Past Accepting new patients

Locations

16 Brentwood Dr
Ste A
Ithaca, NY 14850
Phone (607) 272-7000

16 Brentwood Dr
Ithaca, NY 14850
Phone (607) 272-7000

310 Taughannock Blvd
Fl 4
Ithaca, NY 14850
Phone (607) 269-0100

Interoperability endpoints

  • Direct secure messaging: dblake27154@direct.xtensys.com

Organizations & group practices 2

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 10

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1336157015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BRENTWOOD DR",
            "address_2": "SUITE A",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501863",
            "telephone_number": "607-272-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BRENTWOOD DR",
            "address_2": "SUITE A",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501863",
            "telephone_number": "607-272-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "DEIDRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NY",
            "license": "256896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.