Individual provider Active NPI

Blake Andrew Grider

  • Physician Assistant
  • Alliance, OH
National Provider Identifier
1619670072
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1972 Clark Ave
Alliance, OH 44601-3929
Phone
(800) 992-6682
NPI assigned
Mar 24, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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 Primary

Addresses

Primary practice location

1972 Clark Ave
Alliance, OH 44601-3929

Mailing address

6315 Firestone Rd NE
Canton, OH 44721-3346
Phone (330) 813-8245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231214002905 OH Practitioner - Physician Assistant 9931558038 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Specialists, LLCGroup PAC ID 1850311010, 81 clinicians

Practice addresses (Care Compare)

1111 Lincoln Way E
Massillon, OH 44646-6950
Phone (330) 809-1800

1301 W 1St St
Springfield, OH 45504-1920
Phone (937) 322-6222

1444 N Main St
North Canton, OH 44720-1640
Phone (330) 409-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.51
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Specialists, LLC CurrentSince Apr 26, 2025 Accepting new patients

Locations

1430 Oak Ct
Ste 100
Beavercreek, OH 45430
Phone (937) 404-1101

6210 Brandt Pike
Ste 102
Huber Heights, OH 45424
Phone (937) 236-8630

1301 W 1st St
Springfield, OH 45504
Phone (937) 271-0066

Organizations & group practices 4

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1619670072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 FIRESTONE RD NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447213346",
            "telephone_number": "330-813-8245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1972 CLARK AVE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446013929",
            "telephone_number": "800-992-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIDER",
        "first_name": "BLAKE",
        "middle_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, OH

Sources for this page

Verify at the official NPI Registry.