ROBERT VAN BLAKEBURN (MD) – Family Medicine Physician, NPI 1164419560

ROBERT VAN BLAKEBURN (MD) is a healthcare provider. based in Clinton, Oklahoma. specializing in EMERGENCY MEDICINE, FAMILY PRACTICE, FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 17199 (OK). The NPI Number for ROBERT VAN BLAKEBURN (MD) is 1164419560

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
ROBERT VAN BLAKEBURN (MD)
NPI
1164419560
Phone
(580) 323-2700
Address
800 FRISCO AVE
Enumeration Date
30 September 2005
Last Update Date
2 February 2026

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
5053953000
Graduation Year
1987 (39 years ago)
PAC ID
7416985429
Group Practice PAC ID
0345374690
Professional Enrollment ID
I20241014003394
Address ID
NM875056103SA2085XSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience78
Completeness85
Years active:20State licenses:2Digital endpointsOther names

747 EMERGENCY MEDICINE in OK

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Provider Addresses for ROBERT VAN BLAKEBURN (MD)

  • 800, Frisco Avenue, Clinton, Custer County, Oklahoma, 73601, United States

    CLINTON, OK 736013306

    Phone: (580) 323-2700

    Fax: (580) 323-2276

    Type: Location

  • 800 Frisco Ave

    Clinton, OK 736013306

    Phone: (580) 323-2700

    Fax: (580) 323-2276

    Type: Location

  • 2085 S PACHECO ST

    SANTA FE, NM 875056103

    Phone: (505) 395-3000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $157.

Total Amount is formed as General ($157) + Research ($0) + Ownership ($0) = $157.

Last reported payment date: 2024-10-09 • Largest payer in this snapshot: ABBVIE INC. ($86).

Total Amount

$157

General + Research + Ownership

Payments

8

Total payment records

General Amount

$157

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-10-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20050803000630IEmergency MedicineOKTBD
I20241014003394IFamily PracticeNMTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes2,007637$0
36415Insertion of needle into vein for collection of blood sample860536$0
96372Injection of drug or substance under skin or into muscle377175$0
J0696Injection, ceftriaxone sodium, per 250 mg33756$0
J1100Injection, dexamethasone sodium phosphate, 1 mg30866$0
View full utilization report →

Insurance plans in this area (ZIP 73601)

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Provider's Procedures

ROBERT VAN BLAKEBURN (MD) performs procedures in EMERGENCY MEDICINE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
EMERGENCY MEDICINEOK17003Destruction of 2-14 skin growths3226

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: 0345374690View full group profile
NameSpecialtyState
Internal MedicineNM
Physician AssistantAL
Internal MedicineNM
-NM
Nurse PractitionerNM
-NM
Physician AssistantNM

Reviews

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Frequently asked questions

What is the registry number for ROBERT VAN BLAKEBURN (MD)?
The registry entry for ROBERT VAN BLAKEBURN (MD) shows NPI 1164419560.
Is ROBERT VAN BLAKEBURN (MD)'s NPI status active today?
Active status means ROBERT VAN BLAKEBURN (MD)'s NPI record is not deactivated in the public file.
Which specialty label fits ROBERT VAN BLAKEBURN (MD)?
NPPES ties ROBERT VAN BLAKEBURN (MD) to Family Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit ROBERT VAN BLAKEBURN (MD) in Clinton, Oklahoma?
For routing, start with Clinton, Oklahoma for ROBERT VAN BLAKEBURN (MD), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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