BLAKE ALLAN PETERSON
NPI 1790480549
Emergency Medicine in Buffalo, NY

Q: What is Blake Peterson's NPI number?

The NPI number for Blake Peterson is 1790480549. It was assigned to this individual provider in the NPPES registry on April 3, 2023.

Q: What is Blake Peterson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Blake Peterson was last updated on July 31, 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 April 03, 2023PECOS EnrolledAccepts Medicare Assignment

955 MAIN ST STE 7230, BUFFALO, NY 14203(716) 829-2012(716) 829-3999 Get Directions Write a Review

NPPES record last updated: July 31, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Jul 31, 2026, Apr 3, 2023 (2 updates tracked since 2023).

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About Blake Allan Peterson NPPES

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

BLAKE ALLAN PETERSON (NPI 1790480549) is an individual emergency medicine provider in Buffalo, New York, licensed in New York (343066) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, is affiliated with Kaleida Health, and is a graduate of State University Of New York At Buffalo School Of Medicine (2023).

NPPES Registry Identity

NPI1790480549

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameBLAKE ALLAN PETERSON

Location Address955 MAIN ST STE 7230Buffalo, NY 14203-1121

Mailing Address955 Main St Ste 7230Buffalo, NY 14203-1121 · (716) 829-2012 · Fax (716) 829-3999

Phone(716) 829-2012

Fax(716) 829-3999

Sole ProprietorNo

Medical School CMSState University Of New York At Buffalo School Of MedicineGraduated 2023

Enumeration DateApril 3, 2023

Last NPPES UpdateJuly 31, 20262 updates tracked since enumeration

NPPES CertifiedJuly 31, 2026

✔ NPI 1790480549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in NY · 343066

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

955 MAIN ST STE 7230, Buffalo, NY 14203

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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 and accepts Medicare assignment

Blake Allan Peterson 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 ID5395214639

PECOS Enrollment IDI20260515003268

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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kaleida Health

Acute Care Hospitals · Buffalo, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330005

Location100 High StreetBuffalo, NY 14210 · Erie County

Emergency services Birthing friendly

Brooks-Tlc Hospital System, Inc

Acute Care Hospitals · Dunkirk, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330229

Location529 Central AvenueDunkirk, NY 14048 · Chautauqua County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14203 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

SARAH KHALED ALEM

Student in an Organized Health Care Education/Training Program