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DR. BLAKE ALLEN PETERSON OD
NPI 1942200159
Optometrist in Cleveland, TN

Active since July 29, 2005PECOS EnrolledAccepts Medicare Assignment
2020 KEITH ST NW, CLEVELAND, TN 37311(423) 472-6517(423) 476-8578 Get Directions Write a Review

NPPES record last updated: December 6, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Blake Allen Peterson Od NPPES

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

DR. BLAKE ALLEN PETERSON OD (NPI 1942200159) is an individual optometrist in Cleveland, Tennessee, licensed in Tennessee (ODT1031) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of Southern College Of Optometry (1985).

NPPES Registry Identity

NPI1942200159
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. BLAKE ALLEN PETERSONCredential: OD
Location Address2020 KEITH ST NWCleveland, TN 37311-1351
Mailing Address2020 Keith St NwCleveland, TN 37311-1351 · (423) 472-6517 · Fax (423) 476-8578
Phone(423) 472-6517
Fax(423) 476-8578
Sole ProprietorNo
Medical School CMSSouthern College Of OptometryGraduated 1985
Enumeration DateJuly 29, 2005
Last NPPES UpdateDecember 6, 2007
✔ NPI 1942200159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in TN · ODT1031
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
2020 KEITH ST NW, Cleveland, TN 37311
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Other Identifiers 3

Medicare PIN3596680TN
Medicare NSC0271600001TN
Medicare UPINT61331

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.Insurance ›

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

Dr. Blake Allen Peterson Od 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 ID7214084367
PECOS Enrollment IDI20111114000540
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.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
455 services451 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
344 services226 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
112 services107 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
82 services68 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
51 services51 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
51 services48 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37311 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
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$66.01 typical visit price
range $16.72 – $131.41
Typical copayment $16.50 (range $4.18 – $32.85)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier11 claims11 services$54.15 avg. paid by Medicare
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens V2303
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier11 claims21 services$38.64 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

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

DENNIS CLIFFORD FORD MD
Non-Pharmacy Dispensing Site
2020 KEITH ST NW, STE C
CLEVELAND, TN 37311
Bradley County (423) 614-0535
DR. ELIZABETH ('KARI') CARRIGAN HUDSON O.D.
Optometrist
2020 KEITH ST NW
CLEVELAND, TN 37311
Bradley County (423) 472-6517
FORD CENTER FOR PAIN MANAGEMENT
Pain Medicine (Interventional Pain Medicine)
2020 KEITH ST NW, STE C
CLEVELAND, TN 37311
Bradley County (423) 614-0535
DR. WALTER F PETERSON OD
Optometrist
2020 KEITH ST NW
CLEVELAND, TN 37311
Bradley County (423) 472-6517
SAMANTHA MACCHIO KAPPERMAN OD
Optometrist
2020 KEITH ST NW
CLEVELAND, TN 37311
Bradley County (423) 472-6517
WALTER F PETERSON OD PC
Optometrist
2020 KEITH ST NW
CLEVELAND, TN 37311
Bradley County (423) 472-6517

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 1942200159. It was assigned to this individual provider in the NPPES registry on July 29, 2005.

Where is Blake Peterson located?

Blake Peterson practices at 2020 Keith St NW, Cleveland, TN 37311. The listed phone number is (423) 472-6517.

What is Blake Peterson's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Blake Peterson enrolled in Medicare?

Yes. Blake Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Blake Peterson accept?

Health plans from BlueCross BlueShield of Tennessee list Blake Peterson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Blake Peterson was last updated on December 6, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.