ROBERT VAN BLAKEBURN (MD) – Family Medicine Physician, NPI 1164419560
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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
| Company | Amount |
|---|---|
| ABBVIE INC. | $86 |
| Nevro Corp. | $22 |
| GlaxoSmithKline, LLC. | $18 |
| Exact Sciences Corporation | $16 |
| Merck Sharp & Dohme LLC | $15 |
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050803000630 | I | Emergency Medicine | OK | TBD |
| I20241014003394 | I | Family Practice | NM | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 2,007 | 637 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 860 | 536 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 377 | 175 | $0 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 337 | 56 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 308 | 66 | $0 |
Insurance plans in this area (ZIP 73601)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| EMERGENCY MEDICINE | OK | 17003 | Destruction of 2-14 skin growths | 32 | 26 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | NM | |
| Physician Assistant | AL | |
| Internal Medicine | NM | |
| - | NM | |
| Nurse Practitioner | NM | |
| - | NM | |
| Physician Assistant | NM |
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