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MR. PAUL A BLAKE IV DO (AS OF 5/31/2020)
NPI 1639799158
Preventive Medicine - Aerospace Medicine in Little Rock Afb, AR

Active since April 24, 2020PECOS Enrolled
1090 ARNOLD DR, LITTLE ROCK AFB, AR 72099(501) 987-7319 Get Directions Write a Review

NPPES record last updated: October 1, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 1, 2021, Sep 13, 2021, Aug 10, 2020 and 1 more (4 updates tracked since 2020).

About Mr. Paul A Blake Iv Do (as Of 5/31/2020) NPPES

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

MR. PAUL A BLAKE IV DO (AS OF 5/31/2020) (NPI 1639799158) is an individual aerospace medicine provider in Little Rock Afb, Arkansas, licensed in Nebraska (2470) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639799158
Entity TypeIndividualMale
Primary Taxonomy2083A0100X
Provider Legal NameMR. PAUL A BLAKE IVCredential: DO (AS OF 5/31/2020)
Location Address1090 ARNOLD DRLittle Rock Afb, AR 72099-4933
Mailing Address1090 Arnold DrLittle Rock Afb, AR 72099-4933 · (501) 987-7319
Phone(501) 987-7319
Sole ProprietorNo
Enumeration DateApril 24, 2020
Last NPPES UpdateOctober 1, 20214 updates tracked since enumeration
NPPES CertifiedOctober 1, 2021
✔ NPI 1639799158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPreventive Medicine · Aerospace MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083A0100X
License✔ Licensed in NE · 2470
Definition
Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures.
1090 ARNOLD DR, Little Rock Afb, AR 72099
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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. Paul A Blake Iv Do (as Of 5/31/2020) 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72099 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
$119.36 typical visit price
range $51.36 – $157.74
Typical copayment $29.84 (range $12.84 – $39.43)
Most-billed visit code 99204
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
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.

MELRITA MAECHEL JOHNSON LCSW
Social Worker (Clinical)
1090 ARNOLD DR
LITTLE ROCK AFB, AR 72099
Pulaski County (501) 987-3080
MRS. TANYA NASHEL MILLER ADC
Counselor (Addiction (Substance Use Disorder))
1090 ARNOLD DR
JACKSONVILLE, AR 72099
Pulaski County (501) 987-7338
COURTNEY MCCULLEY PHARMD.
Pharmacist
1090 ARNOLD DR
LITTLE ROCK AFB, AR 72099
Pulaski County (501) 987-7446
DR. SHARIFA FREIGHTMAN PH.D.
Psychologist (Clinical)
1090 ARNOLD DR
LITTLE ROCK AIR FORCE BASE, AR 72099
Pulaski County (501) 987-3080
CARA D ROTH LCSW
Social Worker (Clinical)
1090 ARNOLD DR
LITTLE ROCK AFB, AR 72099
Pulaski County (501) 987-8811
TAYLOR FLESHMAN RD
Dietitian, Registered
1090 ARNOLD DR
LITTLE ROCK AIR FORCE BASE, AR 72099
Pulaski County (501) 987-2708
MARY EILEEN KELLY
Dental Hygienist
1090 ARNOLD DR
LITTLE ROCK AFB, AR 72099
Pulaski County (501) 987-7304
JACOB ROGIER DNP, CPNP-PC
Nurse Practitioner (Pediatrics)
1090 ARNOLD DR
LITTLE ROCK AFB, AR 72099
Pulaski County (501) 987-3080

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 Paul Blake's NPI number?

The NPI number for Paul Blake is 1639799158. It was assigned to this individual provider in the NPPES registry on April 24, 2020.

Where is Paul Blake located?

Paul Blake practices at 1090 Arnold Dr, Little Rock Afb, AR 72099. The listed phone number is (501) 987-7319.

What is Paul Blake's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Aerospace Medicine, with taxonomy code 2083A0100X.

Is Paul Blake enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Paul Blake was last updated on October 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.