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SHAUNA ROCHELLE BLAKE FNP
NPI 1568377604
Nurse Practitioner - Family in New London, CT

Active since August 14, 2026PECOS Enrolled
1 SHAWS CV, NEW LONDON, CT 06320(860) 447-8304(860) 447-8720 Get Directions Write a Review

NPPES record last updated: August 20, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 20, 2026, Aug 14, 2026 (2 updates tracked since 2026).

About Shauna Rochelle Blake Fnp NPPES

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

SHAUNA ROCHELLE BLAKE FNP (NPI 1568377604) is an individual family provider in New London, Connecticut, licensed in Connecticut (18119) and active in the NPI registry since August 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2026).

NPPES Registry Identity

NPI1568377604
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHAUNA ROCHELLE BLAKECredential: FNP
Location Address1 SHAWS CVNew London, CT 06320-4902
Mailing Address19 Grand StMiddletown, CT 06457-2705 · (860) 347-6971 · Fax (860) 343-7379
Phone(860) 447-8304
Fax(860) 447-8720
Sole ProprietorYes
Medical School CMSOtherGraduated 2026
Enumeration DateAugust 14, 2026
Last NPPES UpdateAugust 20, 20262 updates tracked since enumeration
NPPES CertifiedAugust 20, 2026
✔ NPI 1568377604 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CT · 18119
1 SHAWS CV, New London, CT 06320
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shauna Rochelle Blake Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID42770604
PECOS Enrollment IDI20260902002111
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 Reassignment

Medicare enrollment records show Shauna Blake reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Health Center Inc
32 mi
Federally Qualified Health Center (FQHC)
675 MAIN ST
Middletown, CT 06457
  • Reassigned Medicare billing, Connecticut enrollment
  • 390 clinicians in this Medicare group
NPI 1952591851 (860) 347-6971

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 06320 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

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.

SKYLA YOUNG CEDANO APRN
Nurse Practitioner
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
MELISSA MILVENAN RN, APRN
Nurse Practitioner
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
STEPHANIE HOWELLS RDH
Dental Hygienist
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
THERESA GRACE BOOTHBY MSN, APRN, NP-C
Nurse Practitioner (Family)
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
LAURIE FELKER RN
Registered Nurse
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
MARIE SALVEMINI LPC
Counselor (Professional)
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
MEREDITH WANIK APRN
Nurse Practitioner (Psychiatric/Mental Health)
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304
MS. ERICA PRESTON PSYD
Psychologist (Clinical)
1 SHAWS CV
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-8304

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 Shauna Blake's NPI number?

The NPI number for Shauna Blake is 1568377604. It was assigned to this individual provider in the NPPES registry on August 14, 2026.

Where is Shauna Blake located?

Shauna Blake practices at 1 Shaws Cv, New London, CT 06320. The listed phone number is (860) 447-8304.

What is Shauna Blake's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shauna Blake enrolled in Medicare?

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

Which organization bills Medicare for Shauna Blake's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shauna Blake reassigns Medicare benefits to Community Health Center Inc (Middletown, CT). The 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 Shauna Blake'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 Shauna Blake was last updated on August 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.