Emily Katherine Blake

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

201913741 Issued in MA

Practice address

12 Jackson St
Hopkinton, MA 01748-2569

Phone

(774) 279-6868

NPI assigned

Jun 28, 2019

Sex

Female

Sole proprietor

No

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 MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blake.emily.bwh@direct.partners.masshiway.net

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.

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment NPD
• Brigham and Women's Hospital

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1093885816
  NPD
• Brigham and Womens Physicians Organization Inc

  • Diagnostic Radiology Physician
  • Boston, MA
  • NPI 1265464598
  NPD (past)

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1821659921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 JACKSON ST",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "017482569",
            "telephone_number": "774-279-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 JACKSON ST",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "017482569",
            "telephone_number": "774-279-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "EMILY",
        "middle_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "201913741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Belesi, DC
• Gina Maria Belsito, D.M.D.
• Robin Lynn Bertuglia, PH.D.
• Birchwood Nutrition Group Inc.
• Dylan Hewins Blackwell, PTA
• Jill Marie Blethen, PT
• Stephanie M. Bodor, MD
• Body N' Beyond, Inc.
• Danielle R Bond, DDS
• Christine Michelle Bonneau, PMHNP

• Pediatric Nurse Practitioner in Hopkinton, MA
• Providers in Hopkinton, MA by specialty
• Pediatric Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.