Andrea Blake, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

DR0052469 Issued in CO

Practice address

4102 Pinion Dr
General Surgery
Usaf Academy, CO 80840-2502

Phone

(719) 333-5140

Fax

(719) 333-5836

NPI assigned

Sep 28, 2008

Last updated

Nov 21, 2013By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

General Surgery

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Emergency Surgeons PCGroup PAC ID 6709213168, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• AdventHealth Littleton Hospital, Littleton, CO, CCN 060113

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ablake@direct.mhg.com

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.

• Premier Emergency Surgeons PC

  • Surgery Physician
  • Littleton, CO
  • NPI 1184262115
  Medicare reassignment Care Compare group NPD

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

• Portercare Adventist Health System

  dba AdventHealth West Littleton ER

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1548800154
  Care Compare affiliation
• Portercare Adventist Health System

  dba Adventhealth Littleton

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1689688988
  Care Compare affiliation
• Portercare Adventist Health System

  dba South Denver Heart Center

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1720628332
  Care Compare affiliation

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

{
    "created_epoch": "1222560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1952551871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "address_2": "GENERAL SURGERY",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5140",
            "fax_number": "719-333-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "address_2": "GENERAL SURGERY",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5140",
            "fax_number": "719-333-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "ANDREA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-28",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR0052469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91585783",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Belleau, PHD
• Andrew Phillip Benfield, DMD, MS
• Christian R Benjamin
• Steven Michael Bennett Jr., D.M.D.
• Douglas John Bird, PA
• Robert Blank, MD
• James Russell Boehlke, MD
• Ashleigh Brewer, RDN, LD
• Majella Gatila-Saldajeno Brown, R.PH., PHARMD
• Michelle Buehner, M.D.

• Surgery Physician in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; 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.