BLAYNE BORDWINE – Pediatric Hospice and Palliative Medicine Physician, NPI 1023898616

BLAYNE BORDWINE is a healthcare provider. based in Piedmont, Oklahoma. specializing in NURSE PRACTITIONER. They hold a License No. 215424 (OK). The NPI Number for BLAYNE BORDWINE is 1023898616

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
BLAYNE BORDWINE
NPI
1023898616
Phone
Not provided
Address
12721 NW 137TH ST
Enumeration Date
2 October 2023
Last Update Date
18 December 2024

Doctor Profile

Medical School Name
VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
2023 (3 years ago)
PAC ID
1951759257
Group Practice PAC ID
5991105876
Professional Enrollment ID
I20231128000452
Address ID
OK731044637OK1200XAVEX358
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for BLAYNE BORDWINE

  • 12721 NW 137TH ST

    PIEDMONT, OK 730788149

    Phone:

    Type: Mailing

  • 1200 CHILDRENS AVE

    OKLAHOMA CITY, OK 731044637

    Phone: (405) 271-4700

    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.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-11-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231128000452INurse PractitionerOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 73078)

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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: 5991105876View full group profile
NameSpecialtyState
Diagnostic RadiologyOK
O P H T H A L M O L O G YOK
Certified Registered Nurse Anesthetist (Crna)OK
R H E U M A T O L O G YOK
Nurse PractitionerOK
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)OK
Family Practice, HospitalistOK
Medical OncologyRI
Clinical Social WorkerOK

Reviews

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Frequently asked questions

Can I verify BLAYNE BORDWINE with an NPI only?
You can start verification with NPI 1023898616 for BLAYNE BORDWINE, then check state licensing separately.
Does the file indicate BLAYNE BORDWINE is practicing under active NPI?
Directory data currently reports BLAYNE BORDWINE as active.
What healthcare role does BLAYNE BORDWINE hold?
Scheduling teams often label BLAYNE BORDWINE under Pediatric Hospice and Palliative Medicine Physician. Clinical services aligned with this taxonomy classification.
Does BLAYNE BORDWINE list a practice location?
Patients near Piedmont, Oklahoma may find BLAYNE BORDWINE in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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