Robert B Blake, MD
Individual provider Active NPI Neurology with Special Qualifications in Child Neurology Physician · Indianapolis, IN
NPI 1396035481 · NPPES record last updated Mar 3, 2025
Key facts
- NPI
- 1396035481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician 2084N0402X
- License
- 01078434A (IN)
- Practice address
- 705 Riley Hospital Dr
Indianapolis, IN 46202-5109 - Phone
- (317) 948-7450
- Fax
- (317) 968-1193
- NPI assigned
- Apr 11, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- Baylor College of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Iu Health Medical Group LLC
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170519001285 | IN | Practitioner - Neurology |
2365719432 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group Riley Specialists, LLC | Current |
Accepting new patients | |
| Indiana Clinic-Neurology, LLC | Current |
Accepting new patients | |
| Iu Health Medical Group, LLC | Current |
Accepting new patients |
Locations
3879 Reliable Pkwy
Chicago, IL 60686
350 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-9874
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
Interoperability endpoints
- rblake3@direct.iuhealth.org
- rblake42154@direct.eskenazihealth.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Epilepsy Physician | 2084E0001X | 01078434A | IN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 01078434A | IN | Yes |
Addresses
Primary practice location
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
3333 Burnet Avenue
ML 2015
Cincinnati, OH 45229-3039
Phone (513) 636-4222
Other practice location 2
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300002988 | Medicaid | IN | |
| 000001098706 | Other | IN | ANTHEM PTAN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | RBLAKE3@direct.iuhealth.org | ||
| Direct Messaging Address | RBLAKE3@direct.iuhealth.org | Direct |
Other providers in Indianapolis, IN
- Ethan Jeffrey Blake
- Hillary S Blake
- Kara Mikayla Blake
- Melinda K Blake
- Rhonda J. Blake
- Robert R. Blake
- Douglas Anthony Blakely
- Makala Blakely
- Lakeita Lynn Blakey
- Benjamin E. Blakley
All providers in Indianapolis, IN · Neurology with Special Qualifications in Child Neurology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.