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JASON JOSEF BLAKE LCSW
NPI 1780730101
Social Worker - Clinical in Loves Park, IL

Active since January 26, 2007PECOS Enrolled
7124 WINDSOR LAKE PKWY, SUITE # 10, LOVES PARK, IL 61111(815) 988-3142 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jason Josef Blake Lcsw NPPES

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

JASON JOSEF BLAKE LCSW (NPI 1780730101) is an individual clinical provider in Loves Park, Illinois and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780730101
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJASON JOSEF BLAKECredential: LCSW
Location Address7124 WINDSOR LAKE PKWY, SUITE # 10Loves Park, IL 61111-3800
Mailing Address7124 Windsor Lake Pkwy, Suite # 10Loves Park, IL 61111-3800 · (815) 988-3142
Phone(815) 988-3142
Sole ProprietorYes
Enumeration DateJanuary 26, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1780730101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
7124 WINDSOR LAKE PKWY, Loves Park, IL 61111
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jason Josef Blake Lcsw 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jason Blake reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Georgina Srinivas Rao, M.D., S.C.
46 mi
Psychiatry
1024 W MAIN ST
Saint Charles, IL 60174
  • Reassigned Medicare billing, Illinois enrollment
  • 12 clinicians in this Medicare group
NPI 1831344480 (630) 262-2640
Nexumhc Consultants, PLLC
71 mi
Clinical
7040 N RIDGEWAY AVE STE 102
Lincolnwood, IL 60712
  • Reassigned Medicare billing, Illinois enrollment
  • 44 clinicians in this Medicare group
NPI 1851082598 (773) 945-1994

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61111 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
$0.00 typical visit price
range $54.80 – $168.44
Typical copayment $0.00 (range $13.70 – $42.11)
Most-billed visit code NA
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
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 5

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

VICTORIA M. HOMINICK LCSW
Social Worker (Clinical)
7124 WINDSOR LAKE PKWY, SUITE 17
LOVES PARK, IL 61111
Winnebago County (815) 282-1807
MR. JOHN ANDREW BUDZYNSKI M.A, L.C.P.C.
Counselor (Professional)
7124 WINDSOR LAKE PKWY, SUITE # 10
LOVES PARK, IL 61111
Winnebago County (815) 633-8688
MRS. KAREN G. PLATZBECKER LPC
Counselor (Professional)
7124 WINDSOR LAKE PKWY
LOVES PARK, IL 61111
Winnebago County (815) 520-7730
BRIDGEWOOD COUNSELING
Social Worker (Clinical)
7124 WINDSOR LAKE PKWY
LOVES PARK, IL 61111
Winnebago County (815) 315-7611
BUDZYNSKI COUNSELING SERVICES INC.
Counselor (Professional)
7124 WINDSOR LAKE PKWY, SUITE # 10
LOVES PARK, IL 61111
Winnebago County (815) 633-8688

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 Jason Blake's NPI number?

The NPI number for Jason Blake is 1780730101. It was assigned to this individual provider in the NPPES registry on January 26, 2007.

Where is Jason Blake located?

Jason Blake practices at 7124 Windsor Lake Pkwy Suite # 10, Loves Park, IL 61111. The listed phone number is (815) 988-3142.

What is Jason Blake's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jason Blake enrolled in Medicare?

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

Which organizations bill Medicare for Jason Blake's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jason Blake reassigns Medicare benefits to 2 organizations: Georgina Srinivas Rao, M.D., S.C. (Saint Charles, IL) and Nexumhc Consultants, PLLC (Lincolnwood, IL). Each 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 Jason 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 Jason Blake was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.