Blake Ducos

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01956200 Issued in NJ

Practice address

390 Route NJ 10
Suite 202
Randolph, NJ 07869

Phone

(973) 895-9925

Fax

(973) 895-9927

NPI assigned

Sep 15, 2020

Last updated

Sep 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Fox Rehabilitation Services IncGroup PAC ID 0143133009, 1,169 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Sicklerville, NJ
  • NPI 1215487772

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Fox Rehabilitation Services Inc

  • Physical Therapist
  • Wilmington, DE
  • NPI 1326092503

  NJ

  Medicare reassignment Care Compare group NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Randolph, NJ
  • NPI 1104376680

  Physical Therapist

  NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Whitestone, NY
  • NPI 1487104261

  Physical Therapist

  NPD

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1578178604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 ROUTE NJ 10",
            "address_2": "SUITE 202",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "07869",
            "telephone_number": "973-895-9925",
            "fax_number": "973-895-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCOS",
        "first_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01956200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Jameson Dreher, ANP
• Lisa Marie Drew, LPC
• DS Medical
• Ana Isabel Du Bois
• Antonio Francesco Duardo, DC
• Jacqueline Marie Dupree
• Dynamic Foot & Ankle
• Dari Dyrness-Olsen, LPC
• Menashe East, LSW
• Grigoriy Efros, D.M.D., MS

• Physical Therapist in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.