OLIVIA KEELIN BLAKE CRNP
NPI 1902787997
Nurse Practitioner in Wilkes Barre, PA

Q: What is Olivia Blake's NPI number?

The NPI number for Olivia Blake is 1902787997. It was assigned to this individual provider in the NPPES registry on September 8, 2025.

Q: What is Olivia Blake's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Olivia Blake was last updated on September 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 September 08, 2025PECOS Enrolled

169 N PENNSYLVANIA AVE, WILKES BARRE, PA 18701(570) 346-8147(570) 230-0013 Get Directions Write a Review

NPPES record last updated: September 8, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Olivia Keelin Blake Crnp NPPES

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

OLIVIA KEELIN BLAKE CRNP (NPI 1902787997) is an individual nurse practitioner in Wilkes Barre, Pennsylvania, licensed in Pennsylvania (SP033283) and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1902787997

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameOLIVIA KEELIN BLAKECredential: CRNP

Location Address169 N PENNSYLVANIA AVEWilkes Barre, PA 18701-3603

Mailing Address169 N Pennsylvania AveWilkes Barre, PA 18701-3603 · (570) 346-8147 · Fax (570) 230-0013

Phone(570) 346-8147

Fax(570) 230-0013

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateSeptember 8, 2025

NPPES CertifiedSeptember 8, 2025

✔ NPI 1902787997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in PA · SP033283

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Olivia Keelin Blake Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668961806

PECOS Enrollment IDI20251029000724

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 18701 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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 18

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

NINA M POLIAK M.D.

Pediatrics