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

Dr. Jacob L Blake, MD

Individual provider Anesthesiology Physician · NPI 1154486769

Dr. Jacob L Blake, MD is a Pain Management in Reno, Nevada. Qualified in 2008, 18 years ago. Practices with Custom Physical Therapy Limited Partnership, a 81-clinician group and accepts Medicare assignment. Licensed in California, Nevada and Washington.

Years since qualifying
18
Licensed in
CA, NV, WA
In the registry since
2006
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

5590 Kietzke Ln
Reno, NV 89511-3019
Phone: (775) 323-2080
Fax: (775) 683-9404
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine (Anesthesiology) Physician (primary) Taxonomy 207LP2900X · Licence 14407 (NV)
Anesthesiology Physician Taxonomy 207L00000X · Licence 14407 (NV)
Anesthesiology Physician Taxonomy 207L00000X · Licence A95206 (CA)
Anesthesiology Physician Taxonomy 207L00000X · Licence MD60071790 (WA)
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X · Licence A95206 (CA)
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X · Licence MD60071790 (WA)

Record details

NPI number1154486769
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 26, 2006
Last updated in NPPESJanuary 29, 2019
Mailing address5590 Kietzke Ln, Reno, NV 89511-3019

Medicare enrollment

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

Medicare specialtyPAIN MANAGEMENT
Also practisesANESTHESIOLOGY
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Custom Physical Therapy Limited Partnership — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Reno