Blake Formanek, MD
NPI 1619763307 · Student in an Organized Health Care Education/Training Program · Phoenix, AZ
Enrolled with Medicare as Order and Referring Only - Internal Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Blake Formanek, MD is a Student in an Organized Health Care Education/Training Program provider in Phoenix, AZ (NPI 1619763307).
Provider details
- NPI number
- 1619763307
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-04-17
- Last updated
- 2025-04-18
- Certified
- 2025-04-18
Frequently asked questions
- What is Blake Formanek's NPI number?
- Blake Formanek's National Provider Identifier (NPI) is 1619763307, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Blake Formanek's specialty?
- Blake Formanek is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Blake Formanek located?
- Blake Formanek's practice location on file with NPPES is 1300 N 12th St Ste 508, Phoenix, AZ 85006-2849.
- What is Blake Formanek's phone number?
- The practice phone number listed in the NPPES registry for Blake Formanek is (602) 839-2266.
- Does Blake Formanek accept Medicare?
- Blake Formanek is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Blake Formanek's NPI active?
- Yes — Blake Formanek's NPI (1619763307) is active in the NPPES registry as of the last update on 2025-04-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.