| Andrea Blake, DO | |
|
4102 Pinion Dr, General Surgery, Usaf Academy, CO 80840-2502 | |
| (719) 333-5140 | |
| (719) 333-5836 |
| Full Name | Andrea Blake |
|---|---|
| Gender | Female |
| Speciality | General Surgery |
| Experience | 17 Years |
| Location | 4102 Pinion Dr, Usaf Academy, Colorado |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952551871 | NPI | - | NPPES |
| 91585783 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | DR0052469 (Colorado) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Littleton Adventist Hospital, Centura Health | Littleton, CO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Premier Emergency Surgeons Pc | 6709213168 | 8 |
| Entity Name | Premier Emergency Surgeons Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184262115 PECOS PAC ID: 6709213168 Enrollment ID: O20200224002329 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrea Blake, DO 4102 Pinion Dr, General Surgery, Usaf Academy, CO 80840-2502 Ph: (719) 333-5140 | Andrea Blake, DO 4102 Pinion Dr, General Surgery, Usaf Academy, CO 80840-2502 Ph: (719) 333-5140 |
David Marc Northern, MD Surgery Medicare: Medicare Enrolled Practice Location: 4102 Pinion Dr, Usaf Academy, CO 80840 Phone: 719-333-5140 | |
Dr. Stacy Ann Shackelford, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 4102 Pinion Dr, Usaf Academy, CO 80840 Phone: 719-333-5140 | |
Jared G. Clay, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 4102 Pinion Dr, 10 Mdg, Usaf Academy, CO 80840 Phone: 719-333-5138 Fax: 719-333-5836 | |
Michelle Buehner, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 4102 Pinion Drive, 10th Medical Group, Usaf Academy, CO 80840 Phone: 719-333-5140 |