Deactivated NPI 1700846193 Deactivated / Inactive NPI Male Practitioner

Dr. Jon Kevin Blake , MD

General Practice • Gas City, IN

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jon Blake has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 28, 2006

NPI Deactivation Date September 23, 2021

Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Jon Blake, MD was a registered General Practice practicing in Gas City, IN. Throughout an active medical career spanning 15 years, Dr. Blake provided care at the practice location at 925 E MAIN ST until profile deactivation on 2021-09-23.

Historical Medicare Part B clinical services included established patient outpatient office visit, new patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

925 E Main St

Gas City, IN 469331550

Telephone 7656747889

Fax 7656740553

Associated Practice Facility / Clinic

🏢 Jon Kevin Blake Md Facility NPI 1215559331

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Gas City, IN

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 30.1 Yrs

Regional Practice Density

1 Specialists

Practicing in Gas City, IN (190 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

15.4% 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 (2021)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	54	36	$145.00	$122.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	104	49	$145.00	$103.16
99213 Established patient office or other outpatient visit, typically 15 minutes	27	18	$88.70	$70.85

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	112	50	$145.00	$102.39
99213 Established patient office or other outpatient visit, typically 15 minutes	42	31	$83.00	$69.71
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	27	20	$165.00	$137.38

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	94	43	$145.00	$95.90
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	71	34	$165.00	$129.39
99213 Established patient office or other outpatient visit, typically 15 minutes	19	15	$83.00	$65.04
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	13	13	$300.00	$183.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	106	50	$145.00	$95.47
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	71	34	$165.00	$127.87
99213 Established patient office or other outpatient visit, typically 15 minutes	18	15	$83.00	$64.76
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	12	12	$300.00	$182.73

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License IN 01034169

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Career & Practice History Timeline

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

7 Historical Events

⚠️

NPI Profile Deactivated September 23, 2021

Record deactivated on September 23, 2021

✅

NPI Profile Active September 15, 2010

NPI status registered as active in NPPES database

📍

Updated Practice Location September 15, 2010

Registered at 925 E MAIN ST, GAS CITY, IN 469331550 (Tel: 7656747889)

📍

Updated Business Mailing Address September 15, 2010

Registered at 925 E MAIN ST, PO BOX 40, GAS CITY, IN 469331550 (Tel: 7656747889)

👤

Provider Name / Credentials Updated September 15, 2010

Recorded as JON BLAKE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 15, 2010

General Practice (License #01034169 in IN)

🟢

Initial NPI Registration & Enumeration March 28, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

No patient reviews submitted yet for Dr. Jon Blake. Be the first to share your experience!

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1700846193

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 28, 2006

Last Update: September 15, 2010

Deactivation Date: September 23, 2021

Update or Correct Profile

Mailing Address

925 E Main St, Po Box 40

Gas City, IN 469331550

Phone: 7656747889

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.