NPIMap

Individual provider Active NPI

Patrick Wayne Blackburn, MD

  • Gynecologic Oncology Physician
  • Mesa, AZ
National Provider Identifier
1972999266
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
67910 Issued in AZ
Practice address
6111 E Arbor Ave
Mesa, AZ 85206-6059
Phone
(480) 981-1326
NPI assigned
Apr 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 59600 TN
Gynecologic Oncology Physician 207VX0201X 59600 TN
Gynecologic Oncology Physician 207VX0201X 67910 AZ Primary

Addresses

Primary practice location

6111 E Arbor Ave
Mesa, AZ 85206-6059

Mailing address

PO Box 6423
Chandler, AZ 85246-6423
Phone (480) 245-6286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230810001826 AZ Practitioner - Gynecological Oncology 3779898630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
University of South Florida College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ironwood Physicians PCGroup PAC ID 3577454842, 115 clinicians

Practice addresses (Care Compare)

6111 E Arbor Ave
Mesa, AZ 85206-6059
Phone (480) 981-1326

Hospital & facility affiliations

  • Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
  • Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036
  • Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119
  • Honorhealth Scottsdale Osborn Medical Center Hospital, Scottsdale, AZ, CCN 030038
  • Honorhealth Scottsdale Shea Medical Center Hospital, Scottsdale, AZ, CCN 030087

Merit-based Incentive Payment System (MIPS)

Final score
97.2 of 100Reported as subgroup
Quality
95.99
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of the uterus30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59600TNMDObstetrics & Gynecology Physician
67910AZMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ironwood Physicians, PC CurrentSince Sep 1, 2023 Accepting new patients
Ironwood Physicians, PC CurrentSince Sep 1, 2023 Accepting new patients
Ironwood Physicians, PC Current Accepting new patients
Ironwood Physicians, PC PastSince Aug 18, 2024 Accepting new patients

Locations

3686 S Rome St
Gilbert, AZ 85297
Phone (480) 792-6006

6111 E Arbor Ave
Mesa, AZ 85206
Phone (480) 981-1326

10238 E Hampton Ave
Ste 102
Mesa, AZ 85209
Phone (480) 481-7770

8880 E Desert Cove Ave
Scottsdale, AZ 85260
Phone (480) 314-6670

Organizations & group practices 4

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

Hospital & facility affiliations 5

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1972999266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6423",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466423",
            "telephone_number": "480-245-6286",
            "fax_number": "480-398-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6111 E ARBOR AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066059",
            "telephone_number": "480-981-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "PATRICK",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-13",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "59600",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "TN",
            "license": "59600",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "AZ",
            "license": "67910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.