Mrs Nicole Marie Blake, DPT in Baltimore, MD - Medicare Physical Therapist Provider

Mrs Nicole Marie Blake, DPT is a medicare enrolled "Physical Therapist" provider in Baltimore, Maryland. Her current practice location is 4924 Campbell Blvd, Baltimore, Maryland. You can reach out to her office (for appointments etc.) via phone at (443) 442-2050.

Mrs Nicole Marie Blake is licensed to practice in Maryland (license number 23660) 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 1750676904.

Contact Information

	Mrs Nicole Marie Blake, DPT
	4924 Campbell Blvd, Baltimore, MD 21236-5908
	(443) 442-2050
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Nicole Marie Blake
Gender	Female
Speciality	Physical Therapist
Location	4924 Campbell Blvd, Baltimore, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750676904
Provider Enumeration Date: 06/16/2011
Last Update Date: 02/14/2013

Medicare PECOS Information:

PECOS PAC ID: 9234662669
Enrollment ID: I20241024000256

Medical Identifiers

Medical identifiers for Mrs Nicole Marie Blake such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750676904	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	23660 (Maryland)	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. Mrs Nicole Marie Blake allows following entities to bill medicare on her behalf.

Provider Name	Dg Physical Therapy Pc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1295279198 PECOS PAC ID: 0143503680 Enrollment ID: O20170208000911

Provider Name	Physiotherapy Associates Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1629165634 PECOS PAC ID: 3577470442 Enrollment ID: O20240910000506

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. Mrs Nicole Marie 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
Mrs Nicole Marie Blake, DPT 737 S Decker Ave, Baltimore, MD 21224-3946 Ph: () -	Mrs Nicole Marie Blake, DPT 4924 Campbell Blvd, Baltimore, MD 21236-5908 Ph: (443) 442-2050

Reviews and Comments

Physical Therapist in Baltimore, MD

Liberty Medical &injury Center Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7034 Liberty Rd, Baltimore, MD 21207 Phone: 410-580-9191
Ms. Susan Kay Dubroff, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1708 W Rogers Ave, Baltimore, MD 21209 Phone: 410-578-5224
Rhonda G Stallings, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 707 N Broadway, Kennedy Krieger Institute, Baltimore, MD 21205 Phone: 443-923-9200 Fax: 443-923-9405
Kimberly Ann Cardosa, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2200 Kernan Dr, Baltimore, MD 21207 Phone: 410-448-6323 Fax: 410-448-6338
Joanne Gamble, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5731 Cottonworth Ave, Baltimore, MD 21209 Phone: 410-708-4763
Eric Wunderle, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9000 Franklin Square Dr, Baltimore, MD 21237 Phone: 443-777-7000
Evangeline Lajom Grecia, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 E North Ave, Baltimore, MD 21202 Phone: 443-642-4208

Mrs Nicole Marie Blake, DPT - Medicare Physical Therapist in Baltimore, MD