Paul Anthony Blake, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

14159 Issued in AZ

Practice address

123 N Centennial Way
Ste 252
Mesa, AZ 85201-6693

Phone

(480) 834-8802

Fax

(480) 834-8448

NPI assigned

Aug 31, 2005

Last updated

Mar 2, 2010By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Physical Medicine and Rehabilitation

Education

Medical University of South Carolina College of Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• American Home Health Services, Inc. Home health agency, Mesa, AZ, CCN 037426
• Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065
• Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
• Banner Heart Hospital Hospital, Mesa, AZ, CCN 030105
• Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
• Banner Rehabilitation Hospital-West Inpatient rehabilitation facility, Peoria, AZ, CCN 033042

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• BHSM Rehabilitation, LLC

  • Rehabilitation Hospital
  • Phoenix, AZ
  • NPI 1851921571
  NPD (past)

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

• American Home Health Services, Inc

  • Home Health Agency
  • Mesa, AZ
  • NPI 1114279536
  Care Compare affiliation
• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  Care Compare affiliation
• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284
  Care Compare affiliation
• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation
• Banner Gateway Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1699884858
  Care Compare affiliation
• Banner Heart Hospital

  • Special Hospital
  • Mesa, AZ
  • NPI 1215961248
  Care Compare affiliation
• BHSM Rehabilitation, LLC

  • Rehabilitation Hospital
  • Phoenix, AZ
  • NPI 1851921571

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1659364016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N CENTENNIAL WAY",
            "address_2": "STE 252",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016693",
            "telephone_number": "480-834-8802",
            "fax_number": "480-834-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N CENTENNIAL WAY",
            "address_2": "STE 252",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016693",
            "telephone_number": "480-834-8802",
            "fax_number": "480-834-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "PAUL",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "14159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230673",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackie Lynn Blair-Merritt, PT
• Debra Lynn Blair
• Julie Blair, LMSW
• Lindsay Deanna Blaire, M.S., CCC-SLP
• Daniel Stephen Blake, SURGICAL FIRST ASST
• Yuliya Blake
• India Blakely
• Eddie Lee Blakes Jr., DBH, LIAC
• Melissa Blanchard, M.ED.
• Timothy Blanckaert

• Physical Medicine & Rehabilitation Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.