NPIMap

Individual provider Active NPI

Blake Stepanovich, D.O.

  • Orthopaedic Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1366895872
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
7190 Issued in OK
Practice address
8100 S Walker Ave BLDG a
Oklahoma City, OK 73139-9475
Phone
(405) 632-4468
Fax
(405) 632-0436
NPI assigned
Jul 20, 2016
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2016022465 MO
Orthopaedic Surgery Physician 207X00000X 7190 OK Primary

Addresses

Primary practice location

8100 S Walker Ave BLDG a
Oklahoma City, OK 73139-9475

Mailing address

8100 S Walker Ave BLDG a
Oklahoma City, OK 73139-9475
Phone (405) 632-4468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210701003752 OK Practitioner - Orthopedic Surgery 1850792466 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Oklahoma State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8100 S Walker Ave BLDG a
Southwest Orthopaedic and Reconstructive
Oklahoma City, OK 73139-9475
Phone (405) 632-4468

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement18
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)15
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7190OKMDGeneral Practice Dentistry
2016022465MOMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Orthopaedic Specialists, P.L.L.C. Orthopaedic Surgery CurrentSince Jul 15, 2023 Accepting new patients
Integris Ambulatory Care Corporation CurrentSince Jul 28, 2021 Accepting new patients
Southwest Orthopaedic Specialists, PLLC Orthopaedic Surgery CurrentSince Jul 15, 2023 Accepting new patients
Oklahoma Center for Orthopaedic & Multi-Specialty Surgery, LLC Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients
Integris South Oklahoma City Hospital Corporation Past Accepting new patients
Grady Memorial Hospital Past Accepting new patients

Locations

4833 Integris Pkwy
Ste 150
Edmond, OK 73034
Phone (405) 657-3990

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

401 SW 80th St
Ste 200
Oklahoma City, OK 73139
Phone (405) 601-4227

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

6001 NW 139th St
Ste A
Oklahoma City, OK 73142
Phone (405) 635-3511

8100 S Walker Ave
Oklahoma City, OK 73139
Phone (405) 602-6500

8100 S Walker Ave
Bldg A
Oklahoma City, OK 73139

2506 N Harrison St
Shawnee, OK 74804
Phone (405) 214-0300

1805 Commons Cir
Ste 100C
Yukon, OK 73099
Phone (405) 265-0165

1805 Commons Cir
Ste C
Yukon, OK 73099
Phone (405) 265-0165

Interoperability endpoints

  • Direct secure messaging: bstepanovich218944@direct.integrisok.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/ed29dd2e-7f6b-4b48-93ba-6ba78c79cd2d/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1366895872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 S WALKER AVE BLDG A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399475",
            "telephone_number": "405-632-4468",
            "fax_number": "405-632-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 S WALKER AVE BLDG A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399475",
            "telephone_number": "405-632-4468",
            "fax_number": "405-632-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPANOVICH",
        "first_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-20",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2016022465",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OK",
            "license": "7190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.