John A Blake, PA-C - Medicare Physician Assistant in Shallotte, NC

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John A Blake, PA-C is a medicare enrolled "Physician Assistant" in Shallotte, North Carolina. He graduated from nursing school in 2001 and has 25 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Columbus Family Medical Pa and his current practice location is 712 Village Rd Sw Ste 104, Shallotte, North Carolina. You can reach out to his office (for appointments etc.) via phone at (910) 754-7607.

John A Blake is licensed to practice in North Carolina (license number 103290NC) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1780726570.

Contact Information

John A Blake, PA-C
712 Village Rd Sw Ste 104,
Shallotte, NC 28470-3449
(910) 754-7607
(910) 754-7608

Map and Direction




Provider's Profile

Full NameJohn A Blake
GenderMale
SpecialityPhysician Assistant
Experience25 Years
Location712 Village Rd Sw Ste 104, Shallotte, North Carolina
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • John A Blake graduated from nursing school in 2001
  NPI Data:
  • NPI Number: 1780726570
  • Provider Enumeration Date: 02/12/2007
  • Last Update Date: 06/03/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 1658332325
  • Enrollment ID: I20041105000347

Medical Identifiers

Medical identifiers for John A Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780726570NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 103290NC (North Carolina)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Novant Health Brunswick Medical CenterSupply, NCHospital

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. John A Blake allows following entities to bill medicare on his behalf.
Entity NameColumbus Family Medical PA
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114028859
PECOS PAC ID: 2769568492
Enrollment ID: O20080320000662
Entity NameCommunity Support Agency, LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447393020
PECOS PAC ID: 5294916730
Enrollment ID: O20110216001043

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. John A 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 AddressPractice Location Address
John A Blake, PA-C
712 Village Rd Sw Ste 104,
Shallotte, NC 28470-3449

Ph: (910) 754-7607		John A Blake, PA-C
712 Village Rd Sw Ste 104,
Shallotte, NC 28470-3449

Ph: (910) 754-7607

Reviews and Comments


Physician Assistant Nurses in Shallotte, NC

Katy Flinn Johnson, PA-C
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Practice Location: 5145 Sellers Rd, Shallotte, NC 28470
Phone: 910-754-4441    Fax: 910-754-5307
Jacob Elias,
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Phone: 910-754-2229    
Kaitlyn Ann Madden, PHYSICIAN ASSISTANT
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Practice Location: 5160 Ocean Hwy W, Shallotte, NC 28470
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Faith Farris, PA
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Practice Location: 5272 Ocean Hwy W, Shallotte, NC 28470
Phone: 910-251-9944    Fax: 910-763-4666
Scott Christopher Ganucheau, MSPAS, PA-C, ATC
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Medicare: Accepting Medicare Assignments
Practice Location: 5145 Sellers Rd, Shallotte, NC 28470
Phone: 910-754-4441    Fax: 910-754-5307
Ms. Dorothy Truax, P.A.
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Medicare: Not Enrolled in Medicare
Practice Location: 512 Village Rd Ste 101, Shallotte, NC 28470
Phone: 910-721-4390    Fax: 910-721-4399
Taylor Blair Currall, PA-C
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Medicare: Not Enrolled in Medicare
Practice Location: 204 Smith Ave, Shallotte, NC 28470
Phone: 910-721-4230    Fax: 910-721-4239

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.