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Active NPI 1588098040 Individual Practitioner Male Practitioner

Blake Ernesto Carrillo , PA-C

Physician Assistant - Medical • Miami, FL

Professional Overview & Biography Verified Profile Summary

Blake Carrillo, PA-C is a registered healthcare professional specializing in Physician Assistant - Medical in Miami, FL. Practice services are available at 14150 SW 136TH ST under active NPI credentials.

Frequently performed procedures and clinical services include emergency department visit for life threatening or functioning severity, emergency department visit with moderate level of medical decision making, replacement of knee joint, both sides of knee. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

14150 Sw 136th St

Miami, FL 331865506

Telephone 7862044600
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant - Medical in Miami, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.9 Yrs
State Avg: 15.5 Yrs
Regional Practice Density
171 Specialists

Practicing in Miami, FL (2836 Statewide)

Telehealth Adoption Rate
5.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
90.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2020)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity
26 26 $1792.54 $169.05

Medical Specialties & State Licenses

CMS Verified: 2020-04-28
Physician Assistant - Medical Primary Specialty

NUCC Taxonomy Code: 363AM0700X

State License FL PA9107380

Definition to come...

Secondary Practice Locations

14100 Sw 136th St

Miami, FL 331865506

Phone: 7862044600

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners
Abdul Memon , PA-C

Physician Assistant

NPI 1104128305

Physician Assistant (Certified)

Michael Ronselli , APRN

Nurse Practitioner - Family

NPI 1114625712

Advanced Practice Registered Nurse

Dr. Jose Llach , DO

Emergency Medicine

NPI 1174732705

Doctor of Osteopathic Medicine (D.O.)

Dr. William Heersink , MD

Emergency Medicine

NPI 1316526890

Doctor of Medicine (M.D.)

NPI 1427288109

Doctor of Osteopathic Medicine (D.O.)

Dr. Jennifer Hwang , DO

Emergency Medicine

NPI 1437688215

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location April 28, 2020

Registered at 14150 SW 136TH ST, MIAMI, FL 331865506 (Tel: 7862044600)

📍
Updated Business Mailing Address April 28, 2020

Registered at 173 KINGS WAY, ROYAL PALM BEACH, FL 334111568 (Tel: 7863165665)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 28, 2020

Physician Assistant (License #PA9107380 in FL)

NPI Profile Active August 10, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location August 10, 2016

Registered at 4215 BURNS ROAD, SUITE 100, PALM BEACH GARDENS, FL 334104627 (Tel: 5616947776)

📍
Updated Business Mailing Address August 10, 2016

Registered at 4215 BURNS RD, SUITE 200, PALM BEACH GARDENS, FL 334104625 (Tel: 5616947776)

👤
Provider Name / Credentials Updated August 10, 2016

Recorded as BLAKE CARRILLO, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 10, 2016

Physician Assistant (License #PA9107390 in FL)

🟢
Initial NPI Registration & Enumeration September 02, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1588098040
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 02, 2013
Last Update: April 28, 2020
Sole Proprietor: No

Mailing Address

173 Kings Way

Royal Palm Beach, FL 334111568

Phone: 7863165665

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.