DR. JOHN S BLAKE MD
NPI 1508826587
Dermatology - MOHS-Micrographic Surgery in Roosevelt, UT

Q: What is John Blake's NPI number?

The NPI number for John Blake is 1508826587. It was assigned to this individual provider in the NPPES registry on March 24, 2006.

Q: What is John Blake's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Q: When was this NPI record last updated?

The NPPES record for John Blake was last updated on May 2, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.

Active since March 24, 2006PECOS EnrolledAccepts Medicare Assignment

66.09/100

CMS Quality Rating

210 W 300 N 7-3, ROOSEVELT, UT 84066(435) 722-3971(435) 722-6104 Get Directions Write a Review

NPPES record last updated: May 2, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. John S Blake Md NPPES

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

DR. JOHN S BLAKE MD (NPI 1508826587) is an individual mohs-micrographic surgery provider in Roosevelt, Utah, licensed in Utah (49109901205) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Uintah Basin Medical Center, and is a graduate of University Of Utah School Of Medicine (1988).

NPPES Registry Identity

NPI1508826587

Entity TypeIndividualMale

Primary Taxonomy207ND0101X

Provider Legal NameDR. JOHN S BLAKECredential: MD

Location Address210 W 300 N 7-3Roosevelt, UT 84066

Mailing Address210 W 300 N 7-3Roosevelt, UT 84066 · (435) 722-3971 · Fax (435) 722-6104

Phone(435) 722-3971

Fax(435) 722-6104

Sole ProprietorYes

Medical School CMSUniversity Of Utah School Of MedicineGraduated 1988

Enumeration DateMarch 24, 2006

Last NPPES UpdateMay 2, 2017

✔ NPI 1508826587 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

License✔ Licensed in UT · 49109901205

Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

210 W 300 N 7-3, Roosevelt, UT 84066

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Other Identifiers 4

Medicare NSC1068670001UT

Medicare UPINE49176UT

Medicare ID-Type Unspecified006486031UT

MedicaidD3948UT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah 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

Dr. John S Blake Md 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 ID3173651395

PECOS Enrollment IDI20100510000420

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

Medicare enrollment records show John Blake reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Uintah Basin Medical Center

0.9 mi

General Acute Care Hospital

250 W 300 N
Roosevelt, UT 84066

Reassigned Medicare billing, Utah enrollment
94 clinicians in this Medicare group

NPI 1871556217 (435) 722-6163

Northeastern Utah Medical Group

25 mi

Family Medicine

210 W 300 N 7-3
Roosevelt, UT 84066

Reassigned Medicare billing, Utah enrollment
78 clinicians in this Medicare group

NPI 1982664199 (435) 722-3971

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

Areas of Expertise CMS Part B claims 16

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

1,064 services159 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

413 services266 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

282 services193 patients

Pathology examination of tissue using a microscope, intermediate complexity 88305

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

223 services150 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks 17311

This procedure involves the careful removal of a growth from the head, neck, hands, or feet. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to study its characteristics and determine the nature of the growth.

215 services173 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

174 services139 patients

Biopsy of related skin growth, each additional growth 11103

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

65 services41 patients

Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm 12052

This procedure involves repairing a wound on the face, ears, eyelids, nose, lips, or mouth that measures between 2.6-5.0 cm. The process includes cleaning, suturing if necessary, and dressing the wound to promote healing and prevent infection.

65 services62 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks 17312

This procedure involves the careful removal of abnormal growths from the head, neck, hands, or feet. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any irregularities. The process may be carried out in multiple stages for thorough examination.

40 services32 patients

Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm 12042

This is a procedure to mend a moderate wound between 2.6-7.5 cm on your neck, hands, or feet. It involves cleaning the wound, removing any damaged tissue, and stitching it back together to promote healing and minimize scarring.

33 services30 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

25 services24 patients

Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm 17262

This procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.

25 services23 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less 14060

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

23 services22 patients

Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm 17261

This procedure involves the removal of a cancerous skin growth on the trunk, arms, or legs that is between 0.6 and 1.0 cm in size. The goal is to eliminate the cancerous cells and prevent further spread. The method of destruction may vary, including methods such as surgery, laser, or cryotherapy.

14 services11 patients

Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less 14040

This procedure involves repairing a wound on various body parts by transferring skin from another area. The transferred skin, up to 10.0 sq cm, helps to cover the wound, promoting healing and reducing scarring. It's a common method for treating larger or deeper wounds.

12 services12 patients

Destruction of precancer skin growth, 15 or more growths 17004

This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Uintah Basin Medical Center

Acute Care Hospitals · Roosevelt, UT

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number460019

Location250 West 300 NorthRoosevelt, UT 84066 · Duchesne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84066 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

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

66.09/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

39.7

Promoting Interoperability

100

Improvement Activities

Cost

47.28

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORTHEASTERN UTAH MEDICAL GROUP

Family Medicine

210 W 300 N 7-3
ROOSEVELT, UT 84066

Duchesne County (435) 722-3971

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 John Blake's NPI number?

The NPI number for John Blake is 1508826587. It was assigned to this individual provider in the NPPES registry on March 24, 2006.

Where is John Blake located?

John Blake practices at 210 W 300 N 7-3, Roosevelt, UT 84066. The listed phone number is (435) 722-3971.

What is John Blake's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is John Blake enrolled in Medicare?

Yes. John 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 John Blake's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Blake reassigns Medicare benefits to 2 organizations: Uintah Basin Medical Center (Roosevelt, UT) and Northeastern Utah Medical Group (Roosevelt, UT). 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 John Blake's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does John Blake accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and Select Health list John 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.

Is John Blake affiliated with any hospitals?

According to CMS data, John Blake is affiliated with Uintah Basin Medical Center.

When was this NPI record last updated?

The NPPES record for John Blake was last updated on May 2, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.