JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST) – Physical Therapist, NPI 1154491777

JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST) is a healthcare provider. based in Milwaukie, Oregon. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PHYSCIAL THERAPIST. They hold a License No. 5243 (OR). The NPI Number for JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST) is 1154491777

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST)
NPI
1154491777
Phone
(971) 206-5140
Address
4560 SE INTERNATIONAL WAY
Enumeration Date
9 November 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5032886671
Graduation Year
2006 (20 years ago)
PAC ID
2163671959
Group Practice PAC ID
6507254497
Professional Enrollment ID
I20121011000745
Address ID
OR972321467PO1300XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,808 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OR

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Provider Addresses for JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST)

  • 4560, Southeast International Way, Milwaukie, Metro, Clackamas County, Oregon, 97222, United States

    MILWAUKIE, OR 97222

    Phone: (971) 206-5140

    Fax: (971) 206-5209

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2012-10-11

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
I20121011000745IPhysical Therapist In Private PracticeORTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,00840$0
97140Therapy procedure using manual technique, each 15 minutes41223$0
97116Therapy procedure for walking training, each 15 minutes36128$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes32022$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care8511$0
View full utilization report →

Insurance plans in this area (ZIP 97222)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6507254497View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeNH
Physical Therapist In Private PracticeOR
Occupational Therapist In Private PracticeOR
Qualified Speech Language PathologistOR
Qualified Speech Language PathologistOR
Qualified Speech Language PathologistTX
Physical Therapist In Private PracticeWA
Qualified Speech Language PathologistOR
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeWA

Reviews

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Frequently asked questions

Can I use this page to confirm JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST)'s NPI?
Yes. JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST) is listed with NPI 1154491777 in the public NPI dataset.
Does the file indicate JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST) is practicing under active NPI?
Directory data currently reports JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST) as active.
What healthcare role does JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST) hold?
Scheduling teams often label JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST) under Physical Therapist. Clinical services aligned with this taxonomy classification.
What area does JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST) serve?
JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST)'s listing highlights Milwaukie, Oregon; more addresses can appear in NPPES.
Is the information about JENNIFER SUZANNE BLAKE (PHYSCIAL THERAPIST) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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