Blake Elizabeth Brooks, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

79510 Issued in CT

Practice address

1305 Post Rd Ste 310
Fairfield, CT 06824-6016

Phone

(203) 259-7709

Fax

(203) 255-3585

NPI assigned

Jun 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Blake Elizabeth Friedman Former name

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Pittsburgh School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairfield Dermatology P.C.Group PAC ID 9234201716, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.13 of 100Reported as apm

Quality

82.27

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blake.brooks@slpg.direct-sluhn.org

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.

• Fairfield Dermatology, P.C.

  • Specialist
  • Fairfield, CT
  • NPI 1023295524
  Medicare reassignment Care Compare group NPD
• St. Luke'S Physician Group, Inc.

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  NPD

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1407340888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CARDINAL RD",
            "city": "WESTON",
            "state": "CT",
            "postal_code": "068832405",
            "telephone_number": "203-856-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 POST RD STE 310",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246016",
            "telephone_number": "203-259-7709",
            "fax_number": "203-255-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "BLAKE",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "79510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLAKE",
            "last_name": "FRIEDMAN",
            "middle_name": "ELIZABETH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Juliette Brisman Zuckerman
• Dante A Brittis, MD
• Kelsey Broderick, DPT
• Wendi Brodis, LMHC
• Kathryn Brogan, OD
• Jhasson Virgil Brooks, PT
• Allison Brown, OTR/L
• Gina Valentina Brown, ND
• Karen Lynn Brown, PA-C
• Nathalie Ann Brown

• Dermatology Physician in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.