Individual provider Active NPI

Blake A. McGrane, PSYD

  • Clinical Psychologist
  • Pembroke Pines, FL
National Provider Identifier
1538616644
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY9647 Issued in FL
Practice address
800 E Cypress Dr
Pembroke Pines, FL 33025-4543
Phone
(954) 392-3195
NPI assigned
Sep 7, 2016
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY9647 FL Primary

Addresses

Primary practice location

800 E Cypress Dr
Pembroke Pines, FL 33025-4543

Mailing address

130 Jacaranda Country Club Dr
Plantation, FL 33324-2599
Phone (954) 361-4530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY9674FLMDPsychologist
PY9647FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1538616644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 JACARANDA COUNTRY CLUB DR",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242599",
            "telephone_number": "954-361-4530",
            "fax_number": "954-361-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CYPRESS DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330254543",
            "telephone_number": "954-392-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRANE",
        "first_name": "BLAKE",
        "middle_name": "A.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-07",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.