ELIZABETH ANN BLAKE PMHNP-BC
NPI 1619832508
Nurse Practitioner - Psychiatric/Mental Health in Port Charlotte, FL

Q: What is Elizabeth Blake's NPI number?

The NPI number for Elizabeth Blake is 1619832508. It was assigned to this individual provider in the NPPES registry on December 22, 2025.

Q: What is Elizabeth Blake's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Elizabeth Blake was last updated on May 28, 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.

Active since December 22, 2025PECOS Enrolled

3191 HARBOR BLVD STE A, PORT CHARLOTTE, FL 33952(941) 883-4518(941) 249-4356 Get Directions Write a Review

NPPES record last updated: May 28, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 28, 2026, Dec 22, 2025 (2 updates tracked since 2025).

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About Elizabeth Ann Blake Pmhnp-bc NPPES

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

ELIZABETH ANN BLAKE PMHNP-BC (NPI 1619832508) is an individual psychiatric/mental health provider in Port Charlotte, Florida, licensed in Florida (APRN11043962) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1619832508

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameELIZABETH ANN BLAKECredential: PMHNP-BC

Location Address3191 HARBOR BLVD STE APort Charlotte, FL 33952-6755

Mailing Address3191 Harbor Blvd Ste APort Charlotte, FL 33952-6755 · (941) 883-4518 · Fax (941) 249-4356

Phone(941) 883-4518

Fax(941) 249-4356

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateDecember 22, 2025

Last NPPES UpdateMay 28, 20262 updates tracked since enumeration

NPPES CertifiedMay 28, 2026

✔ NPI 1619832508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in FL · APRN11043962

3191 HARBOR BLVD STE A, Port Charlotte, FL 33952

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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)

Elizabeth Ann Blake Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2961980214

PECOS Enrollment IDI20260129000730

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33952 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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 16

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

KAYLA NICOLE POPE PMHNP

Nurse Practitioner (Psychiatric/Mental Health)