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

Richard W. Blake, PA-C

Individual provider Physician Assistant · NPI 1740235829

Richard W. Blake, PA-C is a Physician Assistant in Wasilla, Alaska. Graduated from University of North Dakota School of Medicine in 2000, 26 years ago. Practices with Cottonwood Creek Clinic LLC, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Alaska.

Years since qualifying
26
Trained at
University of North Dakota School of Medicine
Licensed in
AK
In the registry since
2006
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3600 E Wickersham Way
Wasilla, AK 99654
Phone: (907) 373-5950
Fax: (907) 373-5954
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

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PADA482 (AK)
Physician Assistant Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence 482 (AK)

Record details

NPI number1740235829
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMay 24, 2006
Last updated in NPPESMarch 7, 2023
Certification dateDecember 21, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Graduated 2000 (26 years in practice)
Group practice Cottonwood Creek Clinic Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Wasilla