MR. ANDRE ANTHONY BLAKE P.A.
NPI 1588655682
Physician Assistant - Surgical in Redlands, CA

Q: What is Andre Blake's NPI number?

The NPI number for Andre Blake is 1588655682. It was assigned to this individual provider in the NPPES registry on October 31, 2005.

Q: What is Andre Blake's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Andre Blake was last updated on February 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 October 31, 2005PECOS Enrolled

2 W FERN AVE, REDLANDS, CA 92373(909) 793-3311(909) 335-4190 Get Directions Write a Review

NPPES record last updated: February 3, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 3, 2020, Jun 24, 2017 (2 updates tracked since 2017).

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About Mr. Andre Anthony Blake P.a. NPPES

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

MR. ANDRE ANTHONY BLAKE P.A. (NPI 1588655682) is an individual surgical provider in Redlands, California, licensed in California (PA16708) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588655682

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameMR. ANDRE ANTHONY BLAKECredential: P.A.

Location Address2 W FERN AVERedlands, CA 92373-5916

Mailing AddressPo Box 10069San Bernardino, CA 92423-0069

Phone(909) 793-3311

Fax(909) 335-4190

Sole ProprietorNo

Enumeration DateOctober 31, 2005

Last NPPES UpdateFebruary 3, 20202 updates tracked since enumeration

✔ NPI 1588655682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in CA · PA16708

2 W FERN AVE, Redlands, CA 92373

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Andre Anthony Blake P.a. 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.

Areas of Expertise CMS Part B claims 4

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

100 services20 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

21 services19 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

21 services17 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

16 services16 patients

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.

CYNTHIA L PACHECO AGACNP

Nurse Practitioner (Acute Care)