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BLAKE DALY RD
NPI 1568148336
Dietitian, Registered in Apple Valley, CA

Active since June 26, 2023
19333 BEAR VALLEY RD STE 103, APPLE VALLEY, CA 92308(714) 618-9500 Get Directions Write a Review

NPPES record last updated: May 7, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 7, 2024, Aug 25, 2023 (2 updates tracked since 2023).

About Blake Daly Rd NPPES

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

BLAKE DALY RD (NPI 1568148336) is an individual dietitian, registered in Apple Valley, California, licensed in Mississippi (D-2197) and active in the NPI registry since June 2023. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1568148336
Entity TypeIndividualMale
Primary Taxonomy133V00000X
Provider Legal NameBLAKE DALYCredential: RD
Location Address19333 BEAR VALLEY RD STE 103Apple Valley, CA 92308-5149
Mailing Address415 South 28th Avenue HattiesburgHattiesburg, MS 39401 · (601) 579-5210 · Fax (601) 268-5733
Phone(714) 618-9500
Sole ProprietorNo
Enumeration DateJune 26, 2023
Last NPPES UpdateMay 7, 20242 updates tracked since enumeration
NPPES CertifiedMay 7, 2024
✔ NPI 1568148336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in MS · D-2197
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
19333 BEAR VALLEY RD STE 103, Apple Valley, CA 92308
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Secondary Practice Locations 2

Location 117095 Main St # 100Hesperia, CA 92345-6004 · Phone (714) 618-9500
Location 212550 Hesperia Rd Ste 100Victorville, CA 92395-5873 · Phone (714) 618-9500

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blake Daly Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

2

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

Providence Medical Foundation
Same address
Urology
19333 BEAR VALLEY RD, SUITE 106
Apple Valley, CA 92308
  • Reassigned Medicare billing, California enrollment
  • 1,699 clinicians in this Medicare group
NPI 1053616706 (760) 240-5505
Hattiesburg Clinic PA
1,605 mi
Family Medicine
502 BROAD ST
Columbia, MS 39429
  • Reassigned Medicare billing, Mississippi enrollment
  • 696 clinicians in this Medicare group
NPI 1295835544 (601) 736-8282

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

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 Blake Daly's NPI number?

The NPI number for Blake Daly is 1568148336. It was assigned to this individual provider in the NPPES registry on June 26, 2023.

Where is Blake Daly located?

Blake Daly practices at 19333 Bear Valley Rd Ste 103, Apple Valley, CA 92308. The listed phone number is (714) 618-9500.

What is Blake Daly's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Blake Daly enrolled in Medicare?

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

Which organizations bill Medicare for Blake Daly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Blake Daly reassigns Medicare benefits to 2 organizations: Providence Medical Foundation (Apple Valley, CA) and Hattiesburg Clinic PA (Columbia, MS). 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 Blake Daly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Blake Daly was last updated on May 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.