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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BLAKE ALLAN PETERSON
NPI 1790480549
Emergency Medicine in Buffalo, NY

Active since April 03, 2023PECOS Enrolled
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: August 30, 2026.

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

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 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 (PECOS)

Blake Allan Peterson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-5076
TERRY XIA MD
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-2012
BAILEY MICHAEL MAJTYKA MD
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-2012
KEVIN ALEXANDER DIMAGNO DO
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (585) 414-9386
DR. LESTER ERNESTO BAYONA CHUYE MD
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-6132
ELENA BARBARA HEIDEN PETERS MD
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 645-9707
GABRIELA MARIE KLANSKY D.O.
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-2012
ARSLAN INAYAT MD
Internal Medicine
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-5997

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 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.

Where is Blake Peterson located?

Blake Peterson practices at 955 Main St Ste 7230, Buffalo, NY 14203. The listed phone number is (716) 829-2012.

What is Blake Peterson's specialty?

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

Is Blake Peterson enrolled in Medicare?

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

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 35 days 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.