Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blake Allan Johnson

Individual provider Surgery Physician · NPI 1164938288

Blake Allan Johnson is a Surgery Physician in Boston, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2017.

Licensed in
MA
In the registry since
2017

Practice location Address checks out

55 Fruit St GRB-425
Boston, MA 02114-2696
Phone: (617) 726-2800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 3016538 (MA)

Record details

NPI number1164938288
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 27, 2017
Last updated in NPPESJune 6, 2024
Certification dateJune 6, 2024
Mailing address55 Fruit St Grb 425, Boston, MA 02114-2696

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