George B Blake, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

ME66396 Issued in FL

Practice address

605 S Fremont Ave
Suite a
Tampa, FL 33606-2479

Phone

(813) 251-0209

Fax

(813) 258-0600

NPI assigned

Jun 1, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Otolaryngology

Education

University of South Florida College of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JEEDBA
• Direct secure messaging: george.blake@gbmd.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/JEEDBA/Endpoint/JEEDBA

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.

• George Blake M.D., P.a.

  • Otolaryngology Physician
  • Tampa, FL
  • NPI 1164469151
  Medicare reassignment NPD Authorized official

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

• St. Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1346519816
  Care Compare affiliation
• St. Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1881632818
  Care Compare affiliation

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1962449587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S FREMONT AVE",
            "address_2": "SUITE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062479",
            "telephone_number": "813-251-0209",
            "fax_number": "813-258-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S FREMONT AVE",
            "address_2": "SUITE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062479",
            "telephone_number": "813-251-0209",
            "fax_number": "813-258-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "GEORGE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME66396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379713900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Berlande Blaise, LCSW
• Trisha Lynn Blake-Popham, PA-C
• Patricia Blake-Rahter, PH.D.
• Bridget Blake, ARNP
• Elaine Kelley Blake, L.M.T.
• John Blake, ARNP
• Samantha Blake
• Stella Blake, APRN
• William Campbell Blake, ED.D.
• Bryanna Blakely

• Otolaryngology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Otolaryngology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.