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MARY L. BLAKE ANP-C
NPI 1164780177
Nurse Practitioner - Psychiatric/Mental Health in Charlotte, NC

Active since April 26, 2012PECOS EnrolledAccepts Medicare Assignment
2936 CALDWELL RIDGE PKWY, CHARLOTTE, NC 28213(704) 578-8041 Get Directions Write a Review

NPPES record last updated: August 28, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 4, 2024, Sep 24, 2024, Jul 17, 2023 and 1 more (4 updates tracked since 2016).

About Mary L. Blake Anp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY L. BLAKE ANP-C (NPI 1164780177) is an individual psychiatric/mental health provider in Charlotte, North Carolina, licensed in North Carolina (5005601) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1164780177
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMARY L. BLAKECredential: ANP-C
Location Address2936 CALDWELL RIDGE PKWYCharlotte, NC 28213-5888
Mailing Address2936 Caldwell Ridge PkwyCharlotte, NC 28213-5888 · (704) 578-8041 · Fax (704) 368-8415
Phone(704) 578-8041
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateApril 26, 2012
Last NPPES UpdateAugust 28, 20254 updates tracked since enumeration
NPPES CertifiedAugust 28, 2025
✔ NPI 1164780177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NC · 5005601
2936 CALDWELL RIDGE PKWY, Charlotte, NC 28213
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary L. Blake Anp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517268865
PECOS Enrollment IDI20151210002868
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Mary Blake reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Align Mental Health & Wellness
9.3 mi
Psychiatric/Mental Health
3719 LATROBE DR STE 850H
Charlotte, NC 28211
  • Reassigned Medicare billing, North Carolina enrollment
NPI 1114613908 (704) 578-8041
Mental Health Specialty Group PA
112 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, North Carolina enrollment
  • 104 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088
Grow Healthcare Group PA
657 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, North Carolina enrollment
  • 712 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711
Signify Health Medical Associates, PLLC
939 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, North Carolina enrollment
  • 728 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28213 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Blake's NPI number?

The NPI number for Mary Blake is 1164780177. It was assigned to this individual provider in the NPPES registry on April 26, 2012.

Where is Mary Blake located?

Mary Blake practices at 2936 Caldwell Ridge Pkwy, Charlotte, NC 28213. The listed phone number is (704) 578-8041.

What is Mary Blake's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Mary Blake enrolled in Medicare?

Yes. Mary Blake is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Mary Blake's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Blake reassigns Medicare benefits to 4 organizations: Align Mental Health & Wellness (Charlotte, NC), Mental Health Specialty Group PA (Durham, NC), Grow Healthcare Group PA (Miami, FL) and Signify Health Medical Associates, PLLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Blake's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mary Blake accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and AmeriHealth Caritas Next and 3 other insurers list Mary Blake as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Blake was last updated on August 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.