JONATHAN MICHAEL BLAKE MD
NPI 1205722543
Student in an Organized Health Care Education/Training Program in West Reading, PA
About Jonathan Michael Blake Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JONATHAN MICHAEL BLAKE MD (NPI 1205722543) is an individual student in an organized health care education/training program in West Reading, Pennsylvania, licensed in Pennsylvania (MT235372) and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jonathan Michael Blake Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
WEST READING, PA 19611
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 Jonathan Blake's NPI number?
The NPI number for Jonathan Blake is 1205722543. It was assigned to this individual provider in the NPPES registry on June 13, 2025.
Where is Jonathan Blake located?
Jonathan Blake practices at 420 S 5th Ave, West Reading, PA 19611. The listed phone number is (484) 628-8000.
What is Jonathan Blake's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jonathan Blake enrolled in Medicare?
Yes. Jonathan Blake is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jonathan Blake was last updated on June 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Jonathan Michael Blake, MD · NPI 1205722543
Student in an Organized Health Care Education/Training Program provider in West Reading, Pennsylvania. Individual provider, active in the CMS NPPES registry since June 13, 2025.
## Identity
- **NPI:** 1205722543 (Entity type: Individual)
- **Enumerated:** June 13, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **State license:** MT235372 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 420 S 5TH AVE, West Reading, PA 19611-2143
- **Phone:** (484) 628-8000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** June 13, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1205722543) · Data from the CMS NPPES public registry.