NPIMap

Individual provider Active NPI

Blake Varghese

  • Foot & Ankle Surgery Podiatrist
  • Weston, WI
National Provider Identifier
1598392011
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1300-25 Issued in WI
Practice address
5403 Normandy St
Weston, WI 54476-2217
Phone
(715) 241-8100
Fax
(715) 241-8102
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 1300-25 WI Primary

Addresses

Primary practice location

5403 Normandy St
Weston, WI 54476-2217

Mailing address

5403 Normandy St
Weston, WI 54476-2217

Other practice location 1

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-4598

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.abjc@adena.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20220512000722 WI Practitioner - Podiatry 2860879830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Foot and Ankle Clinic LLCGroup PAC ID 3072514876, 8 clinicians

Practice addresses (Care Compare)

5403 Normandy St
Weston, WI 54476-2217
Phone (715) 241-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue82
Removal of skin lesions1-10
Removal of nail tissue738
Removal or shaving of skin growth461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
760NCMDMental Health Counselor
1300-25WIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Foot and Ankle Clinic LLC CurrentSince Jun 1, 2022 Accepting new patients
Family Foot and Ankle Clinic LLC Foot & Ankle Surgery CurrentSince Jun 1, 2022 Accepting new patients

Locations

737 Dorr St
Antigo, WI 54409
Phone (715) 623-4710

100 S Court St
Merrill, WI 54452
Phone (715) 722-0999

9433 Cty Road J
Minocqua, WI 54548

570 N Main St
Shawano, WI 54166
Phone (715) 298-5949

140 Wilshire Blvd N
Stevens Point, WI 54481
Phone (715) 341-1266

1439 Churchill St
Ste 202
Waupaca, WI 54981
Phone (715) 258-5210

2400 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2022

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

1901 Westwood Center Blvd
Wausau, WI 54401
Phone (715) 355-9424

5403 Normandy St
Weston, WI 54476
Phone (262) 210-7820

611 Veterans Pkwy
Woodruff, WI 54568
Phone (715) 358-8600

Organizations & group practices 2

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1598392011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 NORMANDY ST",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544762217",
            "fax_number": "715-241-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5403 NORMANDY ST",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544762217",
            "telephone_number": "715-241-8100",
            "fax_number": "715-241-8102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "272 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456019031",
            "country_code": "US",
            "telephone_number": "740-779-4598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "1300-25",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.abjc@adena.medicity.net",
            "affiliation": "N",
            "address_1": "272 Hospital Rd",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456019031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.