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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. DIANE R BLAKE M.D.
NPI 1316921182
Pediatrics - Adolescent Medicine in Worcester, MA

Active since December 05, 2005PECOS Enrolled
97.02/100
CMS Quality Rating
55 LAKE AVE N, DEPARTMENT OF ADOLESCENT MEDICINE, WORCESTER, MA 01655(508) 856-5624 Get Directions Write a Review

NPPES record last updated: July 14, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 14, 2026, Nov 10, 2020 (2 updates tracked since 2020).

About Dr. Diane R Blake M.d. NPPES

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

DR. DIANE R BLAKE M.D. (NPI 1316921182) is an individual adolescent medicine provider in Worcester, Massachusetts, licensed in Massachusetts (154470) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS and maintains a secondary practice location in Florence.

NPPES Registry Identity

NPI1316921182
Entity TypeIndividualFemale
Primary Taxonomy2080A0000X
Provider Legal NameDR. DIANE R BLAKECredential: M.D.
Location Address55 LAKE AVE N, DEPARTMENT OF ADOLESCENT MEDICINEWorcester, MA 01655-0002
Mailing AddressPo Box 62, Turnpike StationShrewsbury, MA 01545-0062 · (508) 334-8815 · Fax (508) 334-5374
Phone(508) 856-5624
Sole ProprietorNo
Enumeration DateDecember 5, 2005
Last NPPES UpdateJuly 14, 20262 updates tracked since enumeration
NPPES CertifiedJuly 14, 2026
✔ NPI 1316921182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in MA · 154470
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
55 LAKE AVE N, Worcester, MA 01655
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Other Names 1

Other Name (5)Dr. Diane R Blake-johnson M.d.

Secondary Practice Location 1

Location 110 Main StFlorence, MA 01062-3160 · Phone (413) 341-9400

Other Identifiers 1

Medicaid3169863MA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Diane R Blake M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

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.

HILLARY R. IRONS MD
Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 421-1400
MS. EILEEN A. DUHAMEL NP
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-2710
EWA HRYNISZYN CRNA
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
HELEN COPSEY PA-C
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-8585
DR. ADEPEJU GBADEBO CHAMPION M.D.
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-2731
SOWMYA KORAPATI
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-3550
LAYLA FAKHRZADEH M.D.
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
YOONYIE CHO M.D.
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-1000

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 Diane Blake's NPI number?

The NPI number for Diane Blake is 1316921182. It was assigned to this individual provider in the NPPES registry on December 5, 2005. The provider is also known as Dr. Diane R Blake-Johnson M.D..

Where is Diane Blake located?

Diane Blake practices at 55 Lake Ave N Department Of Adolescent Medicine, Worcester, MA 01655. The listed phone number is (508) 856-5624.

What is Diane Blake's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Diane Blake enrolled in Medicare?

Yes. Diane Blake is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Diane Blake was last updated on July 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days 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.