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IndividualActiveMedicare EnrolledPrescriberCan Order/Refer

Blake Church

OD

Optometrist

NPI: 1104717024New Berlin, Wisconsin, 53151(414) 313-7121Male

About Blake Church

Blake Church, OD, is a male healthcare professional specializing in Optometrist, registered under National Provider Identifier (NPI) number 1104717024. Blake Church received his medical education at OTHER, graduating in 2024.

Their primary practice is located at 16800 W CLEVELAND AVE, New Berlin, Wisconsin 53151. Patients can reach the office at (414) 313-7121. Blake Church is enrolled in Medicare and accepts Medicare patients, is authorized to order and refer Medicare services, is authorized to prescribe medications.

Blake Church has been NPI-registered since 2025.

Key Metrics

Practice Locations

1

Doctor Details

Identity & Credentials

NPI Number
1104717024
Entity Type
Individual
First Name
Blake
Last Name
Church
Credential
OD
Gender
Male
Medical School
OTHER
Graduation Year
2024
Sole Proprietor
No
Status
active

Primary Practice Location

Address
16800 W CLEVELAND AVE
City
New Berlin
State
Wisconsin
ZIP
53151-3533
Country
United States
Phone
(414) 313-7121

Specialty & Taxonomy

Primary Specialty
Optometrist
Classification
Optometrist
Taxonomy Code
152W00000X

NPI Registration

Enumeration Date
Last Updated
Certification Date

Mailing Address

Address
16800 W CLEVELAND AVE
City
NEW BERLIN
State
WI
ZIP
531513533

Medicare Enrollment

Medicare Enrolled
Yes
Can Order/Refer
Yes
Telehealth
No
Excluded
No

Prescriber Information

Authorized Prescriber
Yes

Frequently Asked Questions

What is Blake Church's NPI number?
Blake Church's National Provider Identifier (NPI) is 1104717024. An NPI is a unique 10-digit identification number issued by the Centers for Medicare & Medicaid Services (CMS) to healthcare providers in the United States.
What does Blake Church specialize in?
Blake Church specializes in Optometrist. They received their medical education at OTHER (class of 2024).
Where is Blake Church located?
Blake Church practices at 16800 W CLEVELAND AVE, New Berlin, Wisconsin 53151. You can reach them by phone at (414) 313-7121.
Does Blake Church accept Medicare?
Yes, Blake Church is enrolled in the Medicare program and accepts Medicare patients. They are also authorized to order and refer services under Medicare.
Does Blake Church offer telehealth or virtual visits?
Blake Church does not currently offer telehealth services. In-person visits are required at their practice location.
Can Blake Church prescribe medications?
Yes, Blake Church is an authorized prescriber.

What is an NPI Number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to healthcare providers in the United States by the Centers for Medicare & Medicaid Services (CMS). Required under HIPAA, every healthcare provider who transmits health information electronically must have an NPI. The NPI for Blake Church is 1104717024.