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

Traci Blake, PA

Individual provider Physician Assistant · NPI 1922519271

Traci Blake, PA is a Physician Assistant in Englewood, New Jersey. Graduated from Mercy College in 2017, 9 years ago. Practices with Physician Partners of Englewood PC, a 95-clinician group and accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
9
Trained at
Mercy College
Licensed in
NJ, NY
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

401 S Van Brunt St Ste 3
Englewood, NJ 07631-4600
Phone: (201) 569-2770
Fax: (201) 569-1774
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 25MP00449500 (NJ)
Physician Assistant Taxonomy 363A00000X · Licence 021388 (NY)

Record details

NPI number1922519271
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 13, 2017
Last updated in NPPESJuly 18, 2022
Certification dateJuly 18, 2022
Mailing address401 S Van Brunt St Ste 3, Englewood, NJ 07631-4600

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMERCY COLLEGE
Graduated 2017 (9 years in practice)
Group practice Physician Partners Of Englewood Pc — 95 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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