NPIMap

Individual provider Active NPI

Blake Martin Hill, PA-C

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1396072070
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAL-2927 Issued in CO
Practice address
1600 Specht Point Rd
Suite 127
Fort Collins, CO 80525-4311
Phone
(970) 493-7733
Fax
(970) 493-8745
NPI assigned
Nov 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAL-2927 CO Primary

Addresses

Primary practice location

1600 Specht Point Rd
Suite 127
Fort Collins, CO 80525-4311

Mailing address

1600 Specht Point Rd
Ste 127
Fort Collins, CO 80525-4311
Phone (970) 493-7733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20100624000401 CO Practitioner - Physician Assistant 2264563972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Clinic PCGroup PAC ID 7315914405, 18 clinicians

Practice addresses (Care Compare)

3351 Eastbrook Dr
Suite 100
Fort Collins, CO 80525-5744
Phone (970) 493-7733

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAL-2927COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Clinic PC CurrentSince Aug 12, 2013 Accepting new patients
Heritage Family Medicine Family Medicine Past Accepting new patients

Locations

1600 Specht Point Rd
Ste 127
Fort Collins, CO 80525

3351 Eastbrook Dr
Ste 100
Fort Collins, CO 80525

1000 Lincoln St
Fort Morgan, CO 80701
Phone (970) 542-3320

2988 Ginnala Dr
Loveland, CO 80538
Phone (970) 633-0815

620 Iris Dr
Sterling, CO 80751
Phone (970) 313-2740

Organizations & group practices 3

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 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1396072070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SPECHT POINT RD",
            "address_2": "STE 127",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254311",
            "telephone_number": "970-493-7733",
            "fax_number": "970-493-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SPECHT POINT RD",
            "address_2": "SUITE 127",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254311",
            "telephone_number": "970-493-7733",
            "fax_number": "970-493-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "BLAKE",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-17",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PAL-2927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.