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MRS. KRISTI LYNN BLACKBURN PA-C
NPI 1093471799
Physician Assistant in Greenwood, IN

Active since November 17, 2021Opted out of Medicare · through Feb 23, 2028
1700 W SMITH VALLEY RD # UNITYC-1, GREENWOOD, IN 46142(317) 300-4091 Get Directions Write a Review

NPPES record last updated: November 17, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Kristi Lynn Blackburn Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KRISTI LYNN BLACKBURN PA-C (NPI 1093471799) is an individual physician assistant in Greenwood, Indiana, licensed in Indiana (100002703A) and active in the NPI registry since November 2021. She has opted out of Medicare through February 23, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1093471799
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. KRISTI LYNN BLACKBURNCredential: PA-C
Location Address1700 W SMITH VALLEY RD # UNITYC-1Greenwood, IN 46142-1599
Mailing Address6302 Harmonridge CtIndianapolis, IN 46278-2218 · (317) 550-7292
Phone(317) 300-4091
Sole ProprietorNo
Enumeration DateNovember 17, 2021
NPPES CertifiedNovember 17, 2021
✔ NPI 1093471799 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IN · 100002703A
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1700 W SMITH VALLEY RD # UNITYC-1, Greenwood, IN 46142
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Kristi Lynn Blackburn Pa-c has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 23, 2022 through February 23, 2028.

Opt-Out Effective DateFebruary 23, 2022
Opt-Out In Effect ThroughFebruary 23, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46142 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristi Blackburn's NPI number?

The NPI number for Kristi Blackburn is 1093471799. It was assigned to this individual provider in the NPPES registry on November 17, 2021.

Where is Kristi Blackburn located?

Kristi Blackburn practices at 1700 W Smith Valley Rd # Unityc-1, Greenwood, IN 46142. The listed phone number is (317) 300-4091.

What is Kristi Blackburn's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kristi Blackburn enrolled in Medicare?

No. Kristi Blackburn has opted out of Medicare through February 23, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kristi Blackburn was last updated on November 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.