Individual provider Active NPI

Alexandria Marie Blaylock, PA

  • Physician Assistant
  • Yukon, OK
National Provider Identifier
1770076051
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2940 Issued in OK
Practice address
301 S Mustang Rd
Yukon, OK 73099-6704
Phone
(405) 324-1911
NPI assigned
Jun 11, 2018
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2940 OK Primary

Addresses

Primary practice location

301 S Mustang Rd
Yukon, OK 73099-6704

Mailing address

7134 S Yale Ave Ste 500
Tulsa, OK 74136-6352
Phone (918) 392-4763

Other practice location 1

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 684-2420

Other practice location 2

7220 S Yale Ave
Tulsa, OK 74136-6348
Phone (918) 392-4763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180828002443 OK Practitioner - Physician Assistant 8729337506 Reassigns benefits to 2 organizations
I20211007001761 TX Practitioner - Physician Assistant 8729337506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians
Thomas Luiskutty MD PLCGroup PAC ID 1658652979, 10 clinicians

Practice addresses (Care Compare)

1001 S 41St St E
Three Rivers Health Center
Muskogee, OK 74403-6253
Phone (918) 687-0201

7134 S Yale Ave
Suite 500
Tulsa, OK 74136-6352
Phone (918) 392-4763

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Oct 4, 2021 Accepting new patients
Warren Clinic Inc CurrentSince Aug 12, 2024 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Oct 4, 2021 Accepting new patients
Cherokee Nation Current Accepting new patients
Oca Mustang LP PastSince Jan 19, 2020 Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • Direct secure messaging: aervin324943@direct.saintfrancis.com

Organizations & group practices 11

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 3

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1770076051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7134 S YALE AVE STE 500",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366352",
            "telephone_number": "918-392-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S MUSTANG RD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996704",
            "telephone_number": "405-324-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Rockefeller Dr",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744015075",
            "country_code": "US",
            "telephone_number": "918-684-2420",
            "fax_number": "918-502-7573",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7220 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741366348",
            "country_code": "US",
            "telephone_number": "918-392-4763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAYLOCK",
        "first_name": "ALEXANDRIA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.