Active NPI
Debbian Fletcher-Blake, FNP
- Adult Medicine Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- F331340
- Practice address
- 30 E 33Rd St
5TH Floor
New York, NY 10016-5337 - Phone
- (212) 366-4459
- NPI assigned
- Jul 28, 2005
- Last updated
- Dec 14, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | F331340 | NY | Primary |
Addresses
Primary practice location
30 E 33Rd St
5TH Floor
New York, NY 10016-5337
Mailing address
30 E 33Rd St
5TH Floor
New York, NY 10016-5337
Phone (212) 366-4459
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1996
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
770 E 176TH St
FL 6
Bronx, NY 10460-4617
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F331340 | NY | MD | Adult Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vocational Instruction Project Community Services Inc | Current | Accepting new patients | |
| Vocational Instruction Project Community Services, Inc. | Current | Accepting new patients | |
| Care for the Homeless | Past | Accepting new patients |
Locations
770 E 176th St
Bronx, NY 10460
Phone (718) 583-5150
770 E 176th St
Fl 6
Bronx, NY 10460
Phone (718) 466-8967
Ownership & related parties
All facility ownership & control disclosures 3
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Vocational Instruction Project Community Services, Inc. | Federally qualified health center | Corporate Officer Operational/Managerial Control |
Jun 1, 2018 Jun 1, 2018 |
| Vocational Instruction Project Community Services, Inc. | Federally qualified health center | Corporate Officer Operational/Managerial Control |
Jun 1, 2018 Jun 1, 2018 |
| Morris Heights Health Center, Inc. | Federally qualified health center | Operational/Managerial Control | Nov 19, 2015 |
Owned or controlled facilities with NPI records 3
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Federally Qualified Health Center (FQHC)
- Bronx, NY
- NPI 1669912341
Operational/Managerial Control
-
- Clinic/Center
- Bronx, NY
- NPI 1164880423
Corporate Officer, Operational/Managerial Control
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bronx, NY
- NPI 1851757272
Corporate Officer, Operational/Managerial Control
Organizations & group practices 7
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.
-
- Methadone Clinic
- Bronx, NY
- NPI 1881733830
-
dba Care For The Homeless Briarwood Family Residence
- Federally Qualified Health Center (FQHC)
- Jamaica, NY
- NPI 1225373723
-
dba Care For The Homeless Jackson Avenue Family Residence
- Federally Qualified Health Center (FQHC)
- Bronx, NY
- NPI 1306182076
-
dba Care For The Homeless Springfield Gardens Family Inn
- Federally Qualified Health Center (FQHC)
- Jamaica, NY
- NPI 1720324650
-
dba Care For The Homeless Wards Island
- Federally Qualified Health Center (FQHC)
- New York, NY
- NPI 1932444528
-
- Clinic/Center
- Bronx, NY
- NPI 1164880423
-
dba BLondell Avenue Health Center
- Federally Qualified Health Center (FQHC)
- Bronx, NY
- NPI 1952647430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323820800000",
"number": "1841290046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 E 33RD ST",
"address_2": "5TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100165337",
"telephone_number": "212-366-4459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E 33RD ST",
"address_2": "5TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100165337",
"telephone_number": "212-366-4459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETCHER-BLAKE",
"first_name": "DEBBIAN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-28",
"last_updated": "2011-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "NY",
"license": "F331340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.