BLAKE ELIZABETH BROOKS (MD) – Dermatology Physician, NPI 1407340888
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
100 DERMATOLOGY in RI
Provider Addresses for BLAKE ELIZABETH BROOKS (MD)
593 EDDY ST DEPT OF
PROVIDENCE, RI 029034923
Phone: (401) 444-7959
Type: Mailing
593 EDDY ST
PROVIDENCE, RI 029034923
Phone: (401) 444-7959
Type: Location
Beth Israel Deaconess Medical Center East Campus, 330, Brookline Avenue, Audubon Square, Boston, Suffolk County, Massachusetts, 02215, United States
BOSTON, MA 022155400
Phone: (617) 667-7000
Type: Mailing
40 CARDINAL RD
WESTON, CT 068832405
Phone: (203) 856-8644
Type: Mailing
1305 POST RD STE 310
FAIRFIELD, CT 068246016
Phone: (203) 259-7709
Fax: (203) 255-3585
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: 2024-12-04
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241204002431 | I | Dermatology | CT | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 63 | 54 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 53 | 23 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 41 | 40 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 40 | 40 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 37 | 37 | $0 |
Insurance plans in this area (ZIP 02903)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | CT | |
| Physician Assistant | NY | |
| Nurse Practitioner | CT | |
| Physician Assistant | CT | |
| D E R M A T O L O G Y | CT | |
| Nurse Practitioner | CT | |
| D E R M A T O L O G Y | CT | |
| D E R M A T O L O G Y | CT |
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