Janice Blake, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in S Glastonbury, Connecticut. Her current practice location is
181 Thompson St, S Glastonbury, Connecticut. You can reach out to her office (for appointments etc.) via phone at
(860) 266-7826.
Janice Blake is licensed to practice in Connecticut (license number 8329) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1548822000.
Provider's Profile
Full Name | Janice Blake |
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Gender | Female |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 181 Thompson St, S Glastonbury, Connecticut |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1548822000
- Provider Enumeration Date: 07/05/2019
- Last Update Date: 06/15/2021
Medicare PECOS Information:
- PECOS PAC ID: 4284060526
- Enrollment ID: I20200205002681
Medical Identifiers
Medical identifiers for Janice Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1548822000 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | 8329 (Connecticut) | Secondary |
363LP0200X | Nurse Practitioner - Pediatrics | 8329 (Connecticut) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 8329 (Connecticut) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Janice Blake allows following entities to bill medicare on her behalf.
Entity Name | Catholic Charities Inc Archdiocese Of Hartford |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1669566956 PECOS PAC ID: 2567367469 Enrollment ID: O20031204000340 |
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Entity Name | Prohealth Physicians Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1720194053 PECOS PAC ID: 1355246950 Enrollment ID: O20031205000602 |
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Entity Name | Catholic Charities Inc Archdiocese Of Hartford |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1245324516 PECOS PAC ID: 2567367469 Enrollment ID: O20040521000152 |
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Entity Name | Catholic Charities Inc Archdiocese Of Hartford |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1518051747 PECOS PAC ID: 2567367469 Enrollment ID: O20040928000800 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Janice Blake is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Janice Blake, PMHNP 181 Thompson St, S Glastonbury, CT 06073-2919 Ph: () - | Janice Blake, PMHNP 181 Thompson St, S Glastonbury, CT 06073-2919 Ph: (860) 266-7826 |
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