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Michael Alan Blackburn, D.O.

NPI 1619389525ActiveIndividual· Family Medicine· St Louis Park, MN

Family Medicine (D.O.) with Park Nicollet Clinic, practicing in St Louis Park, Minnesota. 276 Medicare patients in 2024, $21,202 paid; nearly all of their 635 Part D prescriptions were generic (94%). Lists Park Nicollet Methodist Hospital as a hospital affiliation.

Overview

NPI1619389525
StatusActive
Entity typeIndividual
CredentialD.O.
Sole proprietorNo
NPI issuedMay 27, 2014
Last updated in NPPESJul 16, 2021
Certified by providerJul 16, 2021

Specialties and licenses

TaxonomyCodeLicenseState
Family Medicine Primary207Q00000X59660MN

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Family Practice (MN)
Accepts assignmentYes (participating)

Medicare services in 2024

Medicare patients276
Services billed383 across 31 procedure codes
Paid by Medicare$21,202

Part D prescriptions in 2024

Prescriptions (claims)635 · 649 30-day fills
Patients390
Total drug cost$7,252
Generic share94% of claims

Medicare sources and data years

Education and affiliations

Graduation year2013
Medicare specialtyFamily Practice

Medical group

Hospital affiliation

Source: CMS Care Compare

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Family Medicine providers in St Louis Park

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