Dr. Diane R Blake, MD
Pediatrics, Adolescent Medicine in Worcester, Massachusetts
1316921182- Practice location
- 55 Lake Ave N, Department Of Adolescent Medicine, Worcester, MA 01655-0002
- Phone
- 508-856-5624
- Fax
- —
- Last updated
- July 14, 2026
Diane R Blake is a Pediatrics, Adolescent Medicine based in Worcester, MA. Diane R Blake practices in Worcester, MA and has the professional credentials of MD. The NPI Number for Diane R Blake is 1316921182 and holds a License No. 154470 (MA). The current practice location address for Diane R Blake is 55 Lake Ave N, Department Of Adolescent Medicine, Worcester, MA 01655-0002 and can be reached out via phone at 508-856-5624.
Provider Profile Details
- NPI Number
- 1316921182
- Provider Name
- Diane R Blake
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 55 Lake Ave N, Department Of Adolescent Medicine, Worcester, MA 01655-0002
- Phone Number
- 508-856-5624
- Primary Taxonomy
- Pediatrics, Adolescent Medicine · 2080A0000X
- Sole Proprietor
- No
- Other Names
- Dr. Diane R Blake-Johnson, MD (Other Name)
- Provider Enumeration Date
- December 5, 2005
- Last Update Date
- July 14, 2026
- Certification Date
- July 14, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 55 Lake Ave N
Department Of Adolescent Medicine
Worcester, MA 01655-0002 - City
- Worcester
- State
- Massachusetts
- Zip
- 01655-0002
- Phone Number
- 508-856-5624
Provider Business Mailing Address Details
- Address
- Po Box 62
Turnpike Station
Shrewsbury, MA 01545-0062 - City
- Shrewsbury
- State
- MA
- Zip
- 01545-0062
- Phone Number
- 508-334-8815
- Fax Number
- 508-334-5374
License Information
- License Number
- 154470
- License State
- MA
- Taxonomy
- Pediatrics, Adolescent Medicine · 2080A0000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Pediatrics, Adolescent Medicine providers near Worcester, MA
View all Pediatrics, Adolescent Medicine providers in Worcester →Frequently Asked Questions
What is the NPI number of Dr. Diane R Blake, MD?
The NPI number of Dr. Diane R Blake, MD is 1316921182. It was assigned on December 5, 2005 and is currently active in the NPPES registry.
What is the specialty of Dr. Diane R Blake, MD?
Dr. Diane R Blake, MD is registered under the primary taxonomy Pediatrics, Adolescent Medicine (code 2080A0000X), licensed in MA under license number 154470.
Where does Dr. Diane R Blake, MD practice?
The practice location is 55 Lake Ave N, Department Of Adolescent Medicine, Worcester, MA 01655-0002. The office can be reached at 508-856-5624 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1316921182 directly on the NPPES registry website.