DR. JEFFREY M BLAKE (MD) – Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician, NPI 1477545127

DR. JEFFREY M BLAKE (MD) is a healthcare provider. based in Anderson, Indiana. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 01040057A (IN). The NPI Number for DR. JEFFREY M BLAKE (MD) is 1477545127

Main info

Male
Sole Proprietor
38 Years Of Experience
Accepts Medicare Assignment
Name
DR. JEFFREY M BLAKE (MD)
NPI
1477545127
Phone
(765) 646-8569
Address
141 W 22ND ST STE 309
Enumeration Date
18 August 2005
Last Update Date
14 November 2024

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3179825222
Graduation Year
1988 (38 years ago)
PAC ID
6103873179
Professional Enrollment ID
I20050401000176
Address ID
IN460605051NO14540NXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness75
Years active:20State licenses:1Digital endpointsOther names

962 OBSTETRICS/GYNECOLOGY in IN

Provider Addresses for DR. JEFFREY M BLAKE (MD)

  • 141 W 22ND ST STE 309

    ANDERSON, IN 460164389

    Phone: (765) 646-8569

    Type: Location

  • 14540 PRAIRIE LAKES BLVD N STE 110

    NOBLESVILLE, IN 460604370

    Phone: (317) 982-5222

    Fax: (317) 982-5223

    Type: Mailing

  • 8840, Commerce Park Place, Indianapolis, Indiana, 46268, United States

    INDIANAPOLIS, IN 462683129

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 65 Open Payments records for all available years, with a total value of $5,798.

Total Amount is formed as General ($5,798) + Research ($0) + Ownership ($0) = $5,798.

Last reported payment date: 2024-12-02 • Largest payer in this snapshot: Axonics, Inc. ($2,769).

Total Amount

$5,798

General + Research + Ownership

Payments

65

Total payment records

General Amount

$5,798

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-02

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-04-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050401000176IObstetrics/GynecologyINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46016)

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Provider's Procedures

DR. JEFFREY M BLAKE (MD) performs procedures in OBSTETRICS/GYNECOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OBSTETRICS/GYNECOLOGYIN51798Ultrasound measurement of bladder capacity after voiding1715

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. JEFFREY M BLAKE (MD)?
DR. JEFFREY M BLAKE (MD) — NPI 1477545127 — is the standard way to identify this listing.
Does CMS list DR. JEFFREY M BLAKE (MD) as active?
Yes — DR. JEFFREY M BLAKE (MD) is active in the NPI listing used on this page.
What is DR. JEFFREY M BLAKE (MD)'s specialty?
The listing groups DR. JEFFREY M BLAKE (MD) with Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician. Clinical services aligned with this taxonomy classification.
Does DR. JEFFREY M BLAKE (MD) list a practice location?
Patients near Anderson, Indiana may find DR. JEFFREY M BLAKE (MD) in results; validate coverage separately.
Is the information about DR. JEFFREY M BLAKE (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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