MRS. KELLY ANN BLAKE (PA-C) – Physician Assistant, NPI 1942487673
Physician Assistant
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,366 PHYSICIAN ASSISTANT in MD
Provider Addresses for MRS. KELLY ANN BLAKE (PA-C)
2400 CRYSTAL CLEAR DR
HANOVER, PA 173318320
Phone: (443) 286-2196
Fax: (806) 454-5705
Type: Mailing
684 POOLE RD STE A
WESTMINSTER, MD 21157
Phone: (443) 286-2196
Type: Location
2004 Shipley Rd
Wilmington, DE 198035248
Phone: (888) 982-8594
Type: Location
150 Sunnyside Blvd
Plainview, NY 118031504
Phone: (888) 982-8594
Type: Location
1000 Crawford Pl Ste 240
Mount Laurel, NJ 080543965
Phone: (888) 982-8594
Type: Location
410 N KROCKS RD
ALLENTOWN, PA 181069283
Phone: (888) 982-8594
Fax: (888) 982-8594
Type: Location
PO BOX 159
BARRINGTON, NJ 080070159
Phone:
Type: Mailing
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: 2023-01-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191015003065 | I | Physician Assistant | PA | TBD |
| I20210325001303 | I | Physician Assistant | NJ | TBD |
| I20230118002988 | I | Physician Assistant | NY | TBD |
| I20230123002151 | I | Physician Assistant | DE | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 2,155 | 295 | $0 |
| G0182 | Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patien | 201 | 63 | $0 |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 146 | 121 | $0 |
| 99496 | Transitional care management services for problem of high complexity | 87 | 75 | $0 |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 87 | 87 | $0 |
Insurance plans in this area (ZIP 17331)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | MD | 90670 | Pneumococcal vaccine for injection into muscle | 39 | 39 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | NM | |
| Physician Assistant | PA | |
| Physician Assistant | NJ | |
| Nurse Practitioner | SC | |
| Physician Assistant | NY | |
| Nurse Practitioner | NJ | |
| Physician Assistant | PA | |
| - | NJ | |
| Physician Assistant | PA | |
| Nurse Practitioner | DE |
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