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

Blake Ducos

Individual provider Physical Therapist · NPI 1578178604

Blake Ducos is a Physical Therapist in Private Practice in Randolph, New Jersey. Qualified in 2020, 6 years ago. Practices with Professional Occupational and Physical Therapy, PLLC, a 493-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
6
Licensed in
NJ
In the registry since
2020
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Practice location Address checks out

390 Route Nj 10 Ste 202
Randolph, NJ 07869
Phone: (973) 895-9925
Fax: (973) 895-9927
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA01956200 (NJ)

Record details

NPI number1578178604
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 15, 2020
Last updated in NPPESSeptember 15, 2020
Certification dateSeptember 14, 2020
Mailing address576 Broadhollow Rd, Melville, NY 11747-5002

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Professional Occupational And Physical Therapy, Pllc — 493 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Randolph