NPIMap

Individual provider Active NPI

Charles Richard Blake, MD

  • Ophthalmology Physician
  • Gainesville, FL
National Provider Identifier
1386645224
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME90057 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-0371
Phone
(352) 392-3451
NPI assigned
Aug 2, 2005
Last updated
Jun 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME90057 FL Primary
Ophthalmology Physician 207W00000X 29828 SC

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-0371

Mailing address

PO Box 100284
Gainesville, FL 32610-0284
Phone (352) 273-8778

Other practice location 1

6201 W Newberry Rd
Gainesville, FL 32605-4305
Phone (352) 265-2020

Other identifiers 12

IdentifierTypeStateIssuer
32840OtherNCOPTICARE
7273542OtherNCAETNA
806940OtherNCCOMMUNITY EYE CARE
806940OtherNCPARTNERS
0800815OtherNCUNITED HEALTHCARE
5902230MedicaidNC
141A6OtherNCBCBS NC
0800815OtherNCMAMSI
GP4696MedicaidSC
OPH174OtherNCPRIMAHEALTH
010129300MedicaidFL
183075OtherNCMEDCOST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20041213000037 FL Practitioner - Ophthalmology 4082671037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Alabama School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

6201 W Newberry Rd
Uf Health the Oaks
Gainesville, FL 32605-4305
Phone (352) 265-9465

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME90057FLMDOphthalmology Physician
29828SCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc Ophthalmology CurrentSince Dec 2, 2013 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince May 26, 2025 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Dec 2, 2013 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince May 26, 2025 Accepting new patients
Duke Health Integrated Practice, Inc. Past Accepting new patients
North Carolina Eye Ear Nose & Throat, PA Ophthalmology Past Accepting new patients
North Carolina Eye Ear Nose & Throat PA Ophthalmology PastSince Jun 16, 2006 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

6201 W Newberry Rd
Gainesville, FL 32605
Phone (352) 265-2020

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: cblake131167@direct.shands.ufl.edu
  • Direct secure messaging: cblake22133@tallahasseememorial.direct-ci.com

Organizations & group practices 8

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 8

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1386645224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100284",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100284",
            "telephone_number": "352-273-8778",
            "fax_number": "352-273-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100371",
            "telephone_number": "352-392-3451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6201 W Newberry Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326054305",
            "country_code": "US",
            "telephone_number": "352-265-2020",
            "fax_number": "352-265-7081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "CHARLES",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME90057",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "29828",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICARE",
            "identifier": "32840",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7273542",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY EYE CARE",
            "identifier": "806940",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "806940",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0800815",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902230",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "141A6",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "0800815",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4696",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMAHEALTH",
            "identifier": "OPH174",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010129300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "183075",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.