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JEROME M BLAKE MD
NPI 1699760546
Pediatrics - Neurodevelopmental Disabilities in Sioux Falls, SD

Active since September 16, 2005PECOS Enrolled
1600 W 22ND ST, SIOUX FALLS, SD 57105(605) 312-1000(605) 312-1001 Get Directions Write a Review

NPPES record last updated: March 13, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerome M Blake Md NPPES

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

JEROME M BLAKE MD (NPI 1699760546) is an individual neurodevelopmental disabilities provider in Sioux Falls, South Dakota, licensed in South Dakota (2228) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699760546
Entity TypeIndividualMale
Primary Taxonomy2080P0008X
Provider Legal NameJEROME M BLAKECredential: MD
Location Address1600 W 22ND STSioux Falls, SD 57105-1521
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074 · (605) 328-7180 · Fax (605) 328-7177
Phone(605) 312-1000
Fax(605) 312-1001
Sole ProprietorNo
Enumeration DateSeptember 16, 2005
Last NPPES UpdateMarch 13, 2015
✔ NPI 1699760546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neurodevelopmental DisabilitiesAllopathic & Osteopathic Physicians
Taxonomy Code2080P0008X
License✔ Licensed in SD · 2228
Definition
A pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions.
1600 W 22ND ST, Sioux Falls, SD 57105
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Other Identifiers 2

Medicare UPIND25175
Medicare PINS42191SD

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jerome M Blake Md 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.

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.

JANELLE VANDE GRIEND APRN-CPNP
Nurse Practitioner
1600 W 22ND ST
SIOUX FALLS, SD 57105
Minnehaha County (605) 312-1000
KAILEN K KRAUSE
Registered Nurse (Pediatrics)
1600 W 22ND ST
SIOUX FALLS, SD 57105
Minnehaha County (605) 312-1000
KAYELYN J. WAGNER M.D.
Pediatrics (Pediatric Hematology-Oncology)
1600 W 22ND ST
SIOUX FALLS, SD 57105
Minnehaha County (605) 312-1000
SYED HARIS ZAMIR KAZMI MD
Pediatrics
1600 W 22ND ST
SIOUX FALLS, SD 57105
Minnehaha County (605) 312-1000
MRS. MORGAN DOLORES COLLINS RN, CDCES
Registered Nurse (Diabetes Educator)
1600 W 22ND ST
SIOUX FALLS, SD 57105
Minnehaha County (605) 312-1000
CHARLES A BROBERG DC, PA,
Physician Assistant
1600 W 22ND ST
SIOUX FALLS, SD 57105
Minnehaha County (605) 312-1000
DR. VISHNU KANALA M.B.B.S.
Hospitalist
1600 W 22ND ST
SIOUX FALLS, SD 57105
Minnehaha County (605) 312-1000
HEATHER A. JOHNSON CNP
Nurse Practitioner
1600 W 22ND ST
SIOUX FALLS, SD 57105
Minnehaha County (605) 312-1000

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 Jerome Blake's NPI number?

The NPI number for Jerome Blake is 1699760546. It was assigned to this individual provider in the NPPES registry on September 16, 2005.

Where is Jerome Blake located?

Jerome Blake practices at 1600 W 22nd St, Sioux Falls, SD 57105. The listed phone number is (605) 312-1000.

What is Jerome Blake's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neurodevelopmental Disabilities, with taxonomy code 2080P0008X.

Is Jerome Blake enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jerome Blake was last updated on March 13, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.