Kalob Michael Blackwell, PA-C - Medicare Physician Assistant in Shawnee, OK

Kalob Michael Blackwell, PA-C is a medicare enrolled "Physician Assistant - Medical" in Shawnee, Oklahoma. He graduated from nursing school in 2026 and has 0 years of diverse experience with area of expertise as Physician Assistant. His current practice location is 4409 N Kickapoo Ave, Shawnee, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (405) 242-4100.

Kalob Michael Blackwell is licensed to practice in Oklahoma (license number 6206) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1710805973.

Contact Information

Kalob Michael Blackwell, PA-C
4409 N Kickapoo Ave,
Shawnee, OK 74804-1206
(405) 242-4100
Not Available

Map and Direction




Provider's Profile

Full NameKalob Michael Blackwell
GenderMale
SpecialityPhysician Assistant
Location4409 N Kickapoo Ave, Shawnee, Oklahoma
Accepts Medicare AssignmentsMay be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kalob Michael Blackwell graduated from nursing school in 2026
  NPI Data:
  • NPI Number: 1710805973
  • Provider Enumeration Date: 07/07/2026
  • Last Update Date: 07/09/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 9739646167
  • Enrollment ID: I20260805004804

Medical Identifiers

Medical identifiers for Kalob Michael Blackwell such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710805973NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical 6206 (Oklahoma)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kalob Michael Blackwell is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kalob Michael Blackwell, PA-C
4409 N Kickapoo Ave,
Shawnee, OK 74804-1206

Ph: (405) 242-4100
Kalob Michael Blackwell, PA-C
4409 N Kickapoo Ave,
Shawnee, OK 74804-1206

Ph: (405) 242-4100

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.