DR. RUSSELL R BLAKELEY (M.D.) – Cardiovascular Disease Physician, NPI 1063409639

DR. RUSSELL R BLAKELEY (M.D.) is a healthcare provider. based in Coeur d alene, Idaho. specializing in Cardiovascular Disease Physician. They hold the professional credentials M.D.. They hold a License No. 16299 (TN). The NPI Number for DR. RUSSELL R BLAKELEY (M.D.) is 1063409639

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
DR. RUSSELL R BLAKELEY (M.D.)
NPI
1063409639
Phone
(208) 652-5250
Address
2003 KOOTENAI HEALTH WAY
Enumeration Date
29 September 2005
Last Update Date
27 January 2016

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Secondary Phone
2086255250
Graduation Year
1982 (44 years ago)
PAC ID
0345212585
Group Practice PAC ID
4789641598
Professional Enrollment ID
I20141121001990
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for DR. RUSSELL R BLAKELEY (M.D.)

  • West Kootenai Health Way, Coeur d'Alene, Kootenai County, Idaho, 83815, United States

    COEUR D ALENE, ID 838146051

    Phone: (208) 652-5250

    Fax: (208) 625-5251

    Type: Mailing

  • 606 N THIRD AVE

    SUITE 203

    SANDPOINT, ID 838641594

    Phone: (208) 263-8505

    Fax: (208) 263-2908

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83814)

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Provider's Procedures

DR. RUSSELL R BLAKELEY (M.D.) performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)ID93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report4343

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789641598View full group profile
NameSpecialtyState
Orthopedic SurgeryID
Interventional CardiologyWA
-ID
-WA
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineID
-WA
-ID
-OR
Pulmonary Disease, Critical Care (Intensivists)ID
-ID

Reviews

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Frequently asked questions

What is the standard ID for DR. RUSSELL R BLAKELEY (M.D.) in the U.S.?
In the U.S., DR. RUSSELL R BLAKELEY (M.D.) is identified by NPI 1063409639.
Should I treat DR. RUSSELL R BLAKELEY (M.D.) as an active provider?
Patients and plans typically see DR. RUSSELL R BLAKELEY (M.D.) as active in the national extract.
What type of care does DR. RUSSELL R BLAKELEY (M.D.) provide?
DR. RUSSELL R BLAKELEY (M.D.)'s profile centers on Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. RUSSELL R BLAKELEY (M.D.)?
DR. RUSSELL R BLAKELEY (M.D.) is associated with Coeur D Alene, Idaho in the same public data insurers reference.
Why is information missing for DR. RUSSELL R BLAKELEY (M.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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