Anne M Blake, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

04-37811 Issued in KS

Practice address

11550 Granada St
Leawood, KS 66211-1453

Phone

(913) 451-7546

Fax

(913) 663-2411

NPI assigned

Feb 24, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Anne Miller Former name

Medicare fee-for-service enrollment

Enrolled in KS

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

Dermatology

Education

University of Kansas School of Med (KC/Wich/Sal), 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Skin Cancer Specialists LLCGroup PAC ID 5294721486, 44 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Dermatology and Skin Cancer Specialists, LLC

  • Dermatology Physician
  • Leawood, KS
  • NPI 1205880846
  Medicare reassignment Care Compare group
• Skin & Mohs Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Leawood, KS
  • NPI 1669577524
  NPD
• Dermatology and Skin Cancer Specialists, LLC.

  dba Dermatology and Skin Cancer Center - Lee's Summit

  • Dermatology Physician
  • Lee's Summit, MO
  • NPI 1366632697
  NPD (past)

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1750655585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11550 GRANADA",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662062325",
            "telephone_number": "913-451-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 GRANADA ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111453",
            "telephone_number": "913-451-7546",
            "fax_number": "913-663-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "ANNE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-24",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "125.059721",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "29145",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KS",
            "license": "04-37811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "MILLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bio Solutions, LLC
• Kelsey Biro
• Maha Bishr, MA CCC-SLP
• Shane Dean Bisson, D.C.
• Karen Janelle Black, RN
• Rebecca Nicole Boan, M.S., R.D., L.D.
• Ariel Bock
• Taylor R Bock, M.S., CCC-SLP
• Bodywerkz LLC
• David Adam Boender, D.C.

• Dermatology Physician in Leawood, KS
• Providers in Leawood, KS by specialty
• Dermatology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; 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.