Andrea C Blake, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Washington Township, Michigan. Her current practice location is
57850 Van Dyke, Suite 150, Washington Township, Michigan. You can reach out to her office (for appointments etc.) via phone at
(586) 992-9567.
Andrea C Blake is licensed to practice in Michigan (license number 4301061308) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1073606026.
Physician's Profile
| Full Name | Andrea C Blake |
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| Gender | Female |
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| Speciality | Obstetrics & Gynecology |
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| Location | 57850 Van Dyke, Washington Township, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1073606026
- Provider Enumeration Date: 10/02/2006
- Last Update Date: 11/14/2016
Medicare PECOS Information:
- PECOS PAC ID: 2264685890
- Enrollment ID: I20130110000453
Medical Identifiers
Medical identifiers for Andrea C Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073606026 | NPI | - | NPPES |
| 4389585 | Medicaid | MI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | 4301061308 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Andrea C Blake allows following entities to bill medicare on her behalf.
| Entity Name | Contemporary Obstetrics & Gynecology, Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1528152048
PECOS PAC ID: 9739082603
Enrollment ID: O20040128001022 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Andrea C Blake is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Andrea C Blake, MD
1135 W University Dr, Ste 100,
Rochester, MI 48307-1871
Ph: (248) 656-2022 | Andrea C Blake, MD
57850 Van Dyke, Suite 150,
Washington Township, MI 48307
Ph: (586) 992-9567 |
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