ANDREA BLAKE OTR
NPI 1669088100
Occupational Therapist in Wilton, CT

Active since September 21, 2020Accepts Medicare Assignment
17 WOODCHUCK LN, WILTON, CT 06897(347) 604-4574 Get Directions Write a Review

NPPES record last updated: September 21, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Andrea Blake Otr NPPES

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

ANDREA BLAKE OTR (NPI 1669088100) is an individual occupational therapist in Wilton, Connecticut, licensed in Connecticut (5513) and active in the NPI registry since September 2020. She is a graduate of Other (2020).

NPPES Registry Identity

NPI1669088100
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameANDREA BLAKECredential: OTR
Location Address17 WOODCHUCK LNWilton, CT 06897-3427
Mailing Address17 Woodchuck LnWilton, CT 06897-3427
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateSeptember 21, 2020
NPPES CertifiedSeptember 18, 2020
✔ NPI 1669088100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
License✔ Licensed in CT · 5513
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
17 WOODCHUCK LN, Wilton, CT 06897

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrea Blake Otr is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163903303
PECOS Enrollment IDI20260225002543

Medicare Billing Reassignment

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

Physical Therapist
36 RUSS ST FL 3
Hartford, CT 06106
  • Reassigned Medicare billing, Connecticut enrollment
  • 17 clinicians in this Medicare group

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 Andrea Blake's NPI number?

The NPI number for Andrea Blake is 1669088100. It was assigned to this individual provider in the NPPES registry on September 21, 2020.

Where is Andrea Blake located?

Andrea Blake practices at 17 Woodchuck Ln, Wilton, CT 06897. The listed phone number is (347) 604-4574.

What is Andrea Blake's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Andrea Blake enrolled in Medicare?

Yes. Andrea Blake is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Andrea Blake's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrea Blake reassigns Medicare benefits to Prestige Rehab Ct PLLC (Hartford, 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 Andrea 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 Andrea Blake was last updated on September 21, 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.