DR. BENJAMIN JAY BLAKE (D.O.) – Emergency Medicine Physician, NPI 1104112572

DR. BENJAMIN JAY BLAKE (D.O.) is a healthcare provider. based in Sherman, Texas. specializing in Emergency Medicine Physician. They hold the professional credentials D.O.. They hold a License No. P5037 (TX). The NPI Number for DR. BENJAMIN JAY BLAKE (D.O.) is 1104112572

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
DR. BENJAMIN JAY BLAKE (D.O.)
NPI
1104112572
Phone
(940) 594-8560
Address
536 CARRIAGE ESTATES RD
Enumeration Date
23 June 2011
Last Update Date
18 July 2014

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Secondary Phone
9729818000
Graduation Year
2011 (15 years ago)
PAC ID
3779700224
Group Practice PAC ID
5890688212
Professional Enrollment ID
I20140807000857
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for DR. BENJAMIN JAY BLAKE (D.O.)

  • 536 CARRIAGE ESTATES RD

    SHERMAN, TX 750924444

    Phone: (940) 594-8560

    Type: Mailing

  • 5016 S US HIGHWAY 75

    DENISON, TX 750204584

    Phone: (903) 416-2435

    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: 2014-08-07

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
I20140807000857IEmergency MedicineTXTBD

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 75092)

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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: 5890688212View full group profile
NameSpecialtyState
Emergency MedicineWA
Emergency MedicineLA
-TX
Emergency MedicineHI
Nurse PractitionerTX
Nurse PractitionerTX
Emergency Medicine, Family PracticeTX
Emergency MedicineTX
Emergency MedicineOK
Emergency MedicineAL

Reviews

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Frequently asked questions

What is DR. BENJAMIN JAY BLAKE (D.O.)'s NPI number?
DR. BENJAMIN JAY BLAKE (D.O.)'s NPI is 1104112572 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to DR. BENJAMIN JAY BLAKE (D.O.)?
You should see DR. BENJAMIN JAY BLAKE (D.O.) as active in CMS-hosted NPPES data.
How would a patient describe DR. BENJAMIN JAY BLAKE (D.O.)'s focus?
For DR. BENJAMIN JAY BLAKE (D.O.), the primary taxonomy reads as Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. BENJAMIN JAY BLAKE (D.O.) associated with Sherman?
Public fields place DR. BENJAMIN JAY BLAKE (D.O.) around Sherman, Texas. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for DR. BENJAMIN JAY BLAKE (D.O.) is noted as June 23, 2011 where the registry provides it.

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