DENNIS SIDNEY BLACKSTAD DO
NPI 1710040894
Family Medicine in Broken Arrow, OK
NPI Status: Active since December 19, 2006
Contact Information
511 N ASPEN AVE
BROKEN ARROW, OK
ZIP 74012
Phone: (918) 806-8050
Fax: (918) 995-3773
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Insurance Plans Accepted
- Secondary Locations
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Quality Reporting
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 24
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About DENNIS BLACKSTAD
This page provides the complete NPI Profile along with additional information for Dennis Blackstad, a primary care provider established in Broken Arrow, Oklahoma with a medical specialization in Family Medicine and more than 24 years of experience. He graduated from Oklahoma State University College Of Osteopathic Medicine in 2002. The healthcare provider is registered in the NPI registry with number 1710040894 assigned on December 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 3650 (OK). The provider is registered as an individual and his NPI record was last updated May 2026.
- NPI
- 1710040894
- Provider Name
- DENNIS SIDNEY BLACKSTAD DO
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 511 N ASPEN AVE BROKEN ARROW, OK 74012
- Location Phone
- (918) 806-8050
- Location Fax
- (918) 995-3773
- Mailing Address
- PO BOX 342 BROKEN ARROW, OK 74013
- Mailing Phone
- (918) 806-8050
- Mailing Fax
- (918) 995-3773
- Medical School Name
- OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
- Graduation Year
- 2002
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-19-2006
- Last Update Date
- 05-24-2026
- Code Navigator
A primary care provider (PCP) like Dennis Blackstad sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Secondary Locations
- 11495 S State Highway 51
Coweta, OK 74429
(918) 727-2780
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 3650
- License State
- OK
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | 3650 (OK) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- Harmony by Medica Bronze $0 Copay PCP Visits - PPO
- Harmony by Medica Bronze $0 Copay PCP Visits + Adult Eye Exam - PPO
- Harmony by Medica Bronze Premier - PPO
- Harmony by Medica Bronze Premier + Adult Eye Exam - PPO
- Harmony by Medica Expanded Bronze Standard - PPO
- Harmony by Medica Expanded Bronze Standard + Adult Eye Exam - PPO
- Harmony by Medica Gold $0 Copay PCP Visits - PPO
- Harmony by Medica Gold $0 Copay PCP Visits + Adult Eye Exam - PPO
- Harmony by Medica Gold Share - PPO
- Harmony by Medica Gold Share + Adult Eye Exam - PPO
- Harmony by Medica Gold Standard - PPO
- Harmony by Medica Gold Standard + Adult Eye Exam - PPO
- Harmony by Medica Silver $0 Copay PCP Visits - PPO
- Harmony by Medica Silver $0 Copay PCP Visits + Adult Eye Exam - PPO
- Harmony by Medica Silver Share - PPO
- Harmony by Medica Silver Share + Adult Eye Exam - PPO
- Harmony by Medica Silver Standard - PPO
- Harmony by Medica Silver Standard + Adult Eye Exam - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100171140A | MEDICAID (05) | OK |
Medicare Participation & PECOS Enrollment Status
Dennis Blackstad is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Dennis Blackstad is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3678526969
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20050228000026
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Wheelchairs (DD021N)
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory (HCPCS:E1028)
1 DME suppliers used 12 Medicare Claims 24 Services Paid
DME-Wheelchairs (DD021N)
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory (HCPCS:E1028)
1 DME suppliers used 69 Medicare Claims 69 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
3 DME suppliers used 32 Medicare Claims 32 Services Paid
DME-Wheelchairs (DD009N)
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each (HCPCS:E2386)
1 DME suppliers used 12 Medicare Claims 24 Services Paid
DME-Wheelchairs (DD009N)
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each (HCPCS:E2394)
1 DME suppliers used 12 Medicare Claims 24 Services Paid
DME-Other DME (DE000N)
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes (HCPCS:K0739)
1 DME suppliers used 16 Medicare Claims 105 Services Paid
DME-Wheelchairs (DD009N)
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds (HCPCS:K0823)
1 DME suppliers used 55 Medicare Claims 55 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 25 times for 24 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.61 for a new patient copayment and $23.56 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 74012 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.46
- Minimum New Patient Price $53
- Maximum New Patient Price $162.61
- Average New Patient Copayment $20.61
- Minimum New Patient Copayment $13.25
- Maximum New Patient Copayment $40.65
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.27
- Minimum Established Patient Price $16.68
- Maximum Established Patient Price $132.4
- Average Established Patient Copayment $23.56
- Minimum Established Patient Copayment $4.17
- Maximum Established Patient Copayment $33.1
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 50% | 166 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Closing the Referral Loop: Receipt of Specialist Report | 90% | 291 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Colorectal Cancer Screening | 33% | 318 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Diabetes: Eye Exam | 74% | 118 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| Diabetes: Foot Exam | 38% | 117 |
| The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year | ||
| Diabetes: Medical Attention for Nephropathy | 87% | 118 |
| The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period | ||
| Documentation of Current Medications in the Medical Record | 100% | 4197 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 96% | 6526 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Falls: Screening for Future Fall Risk | 25% | 129 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Health Information Exchange | 0% | 227 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Medication Reconciliation | 73% | 63 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Participation in CAHPS or other supplemental questionnaire | Yes | N/A |
| Participation in the Consumer Assessment of Healthcare Providers and Systems Survey or other supplemental questionnaire items (e.g., Cultural Competence or Health Information Technology supplemental item sets). | ||
| Patient-Specific Education | 22% | 1172 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 35% | 129 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 35% | 845 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Influenza Immunization | 36% | 837 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 98% | 729 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 12% | 311 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide Patient Access | 60% | 1172 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 27% | 1172 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Use of High-Risk Medications in the Elderly | 22% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 129 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
| Use of QCDR for feedback reports that incorporate population health | Yes | N/A |
| Use of a QCDR to generate regular feedback reports that summarize local practice patterns and treatment outcomes, including for vulnerable populations. | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1710040894, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
BROKEN ARROW, OK 74012
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710040894, enumerated as an "individual" on December 19, 2006.
The provider is located at 511 N ASPEN AVE BROKEN ARROW, OK 74012 and the phone number is (918) 806-8050.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Oklahoma, Medica,. Please consult your insurance carrier or call the provider to verify.
