MRS. BREANNE M BLAKE (PA-C) – Physician Assistant, NPI 1245631019

MRS. BREANNE M BLAKE (PA-C) is a healthcare provider. based in Kittanning, Pennsylvania. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. MA057085 (PA). The NPI Number for MRS. BREANNE M BLAKE (PA-C) is 1245631019

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MRS. BREANNE M BLAKE (PA-C)
NPI
1245631019
Phone
Not provided
Address
1 NOLTE DR
Enumeration Date
11 September 2014
Last Update Date
18 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7245451288
Graduation Year
2024 (2 years ago)
PAC ID
6507087970
Group Practice PAC ID
9335051663
Professional Enrollment ID
I20141028002444
Address ID
PA162017129KI300XXBLDG401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness85
Years active:11State licenses:2Digital endpointsOther names

9,691 PHYSICIAN ASSISTANT in PA

Provider Addresses for MRS. BREANNE M BLAKE (PA-C)

  • 1 NOLTE DR

    KITTANNING, PA 162017111

    Phone:

    Type: Mailing

  • 10261 PA-85

    KITTANNING, PA 16201

    Phone: (724) 783-7124

    Type: Location

  • PO BOX 802

    SENECA, PA 163460802

    Phone: (814) 676-5444

    Type: Mailing

  • 1 PARK WAY

    SENECA, PA 163460802

    Phone: (814) 676-5444

    Type: Location

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: 2014-10-28

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
I20141028002444IPhysician AssistantPATBD

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 16201)

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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: 9335051663View full group profile
NameSpecialtyState
Nurse PractitionerPA
Internal MedicinePA
Nurse PractitionerPA
Physician AssistantPA
Emergency MedicinePA
Internal Medicine, Emergency MedicinePA
Pulmonary Disease, Critical Care (Intensivists), Internal MedicinePA
-PA
Physician AssistantPA
Hospitalist, Internal MedicineSC

Reviews

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Frequently asked questions

Does MRS. BREANNE M BLAKE (PA-C) have a public NPI I can cite?
Public records show MRS. BREANNE M BLAKE (PA-C) under NPI 1245631019.
Is MRS. BREANNE M BLAKE (PA-C)'s NPI status active today?
Active status means MRS. BREANNE M BLAKE (PA-C)'s NPI record is not deactivated in the public file.
Which specialty label fits MRS. BREANNE M BLAKE (PA-C)?
NPPES ties MRS. BREANNE M BLAKE (PA-C) to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to MRS. BREANNE M BLAKE (PA-C)?
The directory associates MRS. BREANNE M BLAKE (PA-C) with Kittanning, Pennsylvania. Check all listed addresses for suites or satellite offices.
Can I export MRS. BREANNE M BLAKE (PA-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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