SUZZANE MARIE BLAKE (MD) – Family Medicine Physician, NPI 1689698946

SUZZANE MARIE BLAKE (MD) is a healthcare provider. based in Carthage, Texas. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. J9976 (TX). The NPI Number for SUZZANE MARIE BLAKE (MD) is 1689698946

Main info

Female
34 Years Of Experience
Accepts Medicare Assignment
Name
SUZZANE MARIE BLAKE (MD)
NPI
1689698946
Phone
(903) 315-4160
Address
4188 NW LOOP
Enumeration Date
27 July 2006
Last Update Date
1 August 2012

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Secondary Phone
9033154160
Graduation Year
1992 (34 years ago)
PAC ID
0143224634
Group Practice PAC ID
3072426741
Professional Enrollment ID
I20060914000641
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

Loading map...

Provider Addresses for SUZZANE MARIE BLAKE (MD)

  • 4188, Northwest Loop, Carthage, Panola County, Texas, 75633, United States

    CARTHAGE, TX 756332255

    Phone: (903) 315-4160

    Fax: (903) 690-0801

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2006-09-14

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
I20060914000641IFamily PracticeTXTBD

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 75633)

Loading plans...

Provider's Procedures

SUZZANE MARIE BLAKE (MD) performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINETX90670Pneumococcal vaccine for injection into muscle1111

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: 3072426741View full group profile
NameSpecialtyState
General SurgeryAZ
Internal MedicineTX
Nurse PractitionerTX
Nurse PractitionerTX
-TX
E N D O C R I N O L O G YTX
Nurse PractitionerIL
-NC
Physician AssistantLA
Hospitalist, GastroenterologyTX

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the standard ID for SUZZANE MARIE BLAKE (MD) in the U.S.?
In the U.S., SUZZANE MARIE BLAKE (MD) is identified by NPI 1689698946.
Does the public listing show SUZZANE MARIE BLAKE (MD) as active?
SUZZANE MARIE BLAKE (MD)'s NPI record reflects an active status in NPPES.
What services align with SUZZANE MARIE BLAKE (MD)'s listing?
SUZZANE MARIE BLAKE (MD)'s public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to SUZZANE MARIE BLAKE (MD)?
SUZZANE MARIE BLAKE (MD) is associated with Carthage, Texas in the same public data insurers reference.
Why is information missing for SUZZANE MARIE BLAKE (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

Similar Providers

DR. JOHN F NIELSEN (M.D.)

Family Medicine Physician
Davis Street, Carthage, Panola County, Texas, 75633, United States
NPI: 1003811415

LOUIE ROYCE HILL (M.D.)

Family Medicine Physician
812, North Daniels Street, Carthage, Panola County, Texas, 75633, United States
NPI: 1841285715

ROBERT C WESSMAN (MD)

Family Medicine Physician
PO BOX 549
NPI: 1629044300

DR. CRAIG MCMULLEN (M.D.)

Family Medicine Physician
305 Cottage Rd
NPI: 1487614616

MUHAMMAD FAROOQ (MD)

Family Medicine Physician
Tyler Post Office, Mc Arthur Street, Tyler, Lincoln County, Minnesota, United States
NPI: 1316975667

DR. JIM JASON PHILLIPS (MD)

Family Medicine Physician
PO BOX 519
NPI: 1013086040

JOHN F NIELSEN M D FAMILY MEDICINE PA

Family Medicine Physician
Davis Street, Carthage, Panola County, Texas, 75633, United States
NPI: 1003006065

JASON PHILLIPS M D P A

Family Medicine Physician
PO BOX 519
NPI: 1467620401