Charles Blake, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

19358 Issued in AZ

Practice address

6565 E Carondelet Dr Ste 155
Tucson, AZ 85710

Phone

(520) 849-8900

Fax

(520) 849-7137

NPI assigned

Jan 30, 2006

Sex

Male

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 AZ

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

84.74 of 100Reported as group

Quality

79.16

Promoting interoperability

100

Improvement activities

40

Cost

69.96

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/MmWbh382tKlbvAIA1_DeLlIjYVSwroch/

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.

• Tucson Physician Group Holdings, LLC

  • Interventional Cardiology Physician
  • Tucson, AZ
  • NPI 1356726939
  Medicare reassignment NPD

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1851362792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 E CARONDELET DR STE 155",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857103587",
            "telephone_number": "520-849-8900",
            "fax_number": "520-849-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 E CARONDELET DR STE 155",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85710",
            "telephone_number": "520-849-8900",
            "fax_number": "520-849-7137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2102 N Country Club Rd",
            "address_2": "Bldg B",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857162831",
            "country_code": "US",
            "telephone_number": "520-795-8371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2102 N Country Club Rd",
            "address_2": "Bldg B",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857162831",
            "country_code": "US",
            "telephone_number": "520-795-8371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "19358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Mary Blair, MS, BCBA
• Kacie Blair
• Lacey Marie Blair
• Michelle Blair, LCSW, LISAC
• Rosalee Valdivia Blair, PHARMD
• Christina Blake, FNP, IBCLC
• Donna H Blake, PSYCHOTHERAPIST
• Johannah Blake, PMHNP-BC
• Jonathan Blake, DPT
• Olivia Rachel Blake

• Physical Medicine & Rehabilitation Physician in Tucson, AZ
• Providers in Tucson, 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 Nov 13, 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.
• 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.