Jeffrey D. Blake, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

78308 Issued in MA

Practice address

250 Green St
Gardner, MA 01440-1396

Phone

(978) 630-5050

Fax

(978) 630-5059

NPI assigned

Oct 4, 2005

Last updated

Jun 20, 2011By the provider in NPPES

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 MA

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

Specialty

Obstetrics/Gynecology

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heywood Medical Group Inc.Group PAC ID 6901882836, 111 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

82.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffrey.blake.1@192.direct.athenahealth.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.

• Heywood Medical Group Inc.

  • General Practice Physician
  • Gardner, MA
  • NPI 1699762286

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Athol Memorial Hospital Incorporated

  • Critical Access Hospital
  • Athol, MA
  • NPI 1336120047
  Medicare reassignment NPD
• Henry Heywood Memorial Hospital

  dba Heywood Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879
  Medicare reassignment NPD
• Henry Heywood Memorial Hospital

  dba Heywood Hospital

  • Psychiatric Hospital Unit
  • Gardner, MA
  • NPI 1457685299
  NPD

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1992792980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401396",
            "telephone_number": "978-630-5050",
            "fax_number": "978-630-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401396",
            "telephone_number": "978-630-5050",
            "fax_number": "978-630-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "JEFFREY",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "78308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynnette Bilodeau, RN
• Kristine Marie Bissonnette, PHARMD
• Keith Jeremy Blackburn
• Gregory Andrew Blackman, PAC, ATC
• Stephen Charles Blais
• Julie Ann Blake, D.S.
• Rebecca Ann Blodgett, M.A., LMHC
• Sanjay Reddy Bommu, D.M.D
• Jack R Borey
• Emily Bostock

• Obstetrics & Gynecology Physician in Gardner, MA
• Providers in Gardner, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.