Blake Mcconnell, MD - Medicare Family Medicine in Salem, OR

Blake Mcconnell, MD is a medicare enrolled "Family Medicine" physician in Salem, Oregon. His current practice location is 2485 12th St Se, Salem, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 363-8047.

Blake Mcconnell is licensed to practice in Oregon (license number MD215853) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063074789.

Contact Information

Blake Mcconnell, MD
2485 12th St Se,
Salem, OR 97302-2151
(503) 363-8047
(503) 363-6571



Physician's Profile

Full NameBlake Mcconnell
GenderMale
SpecialityFamily Medicine
Location2485 12th St Se, Salem, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1063074789
  • Provider Enumeration Date: 07/02/2019
  • Last Update Date: 09/06/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2062818925
  • Enrollment ID: I20230912000298

Medical Identifiers

Medical identifiers for Blake Mcconnell such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063074789NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 12439658-1205 (Utah)Secondary
207Q00000XFamily Medicine MD215853 (Oregon)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Blake Mcconnell allows following entities to bill medicare on his behalf.
Entity NameSalem Health West Valley
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245237486
PECOS PAC ID: 7810804630
Enrollment ID: O20040225000830

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Entity NameSalem Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265431829
PECOS PAC ID: 8628986668
Enrollment ID: O20040309001131

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› Verified 1 days ago

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blake Mcconnell is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Blake Mcconnell, MD
Po Box 13129,
Salem, OR 97309-1129

Ph: () -
Blake Mcconnell, MD
2485 12th St Se,
Salem, OR 97302-2151

Ph: (503) 363-8047

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› Verified 1 days ago


Family Medicine Doctors in Salem, OR

Dr. Bethany Wohletz, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1160 Wallace Rd Nw, Salem, OR 97304
Phone: 503-304-5716    Fax: 503-304-5719
Samantha Easterly, DO
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 2020 Capitol St Ne, Salem, OR 97301
Phone: 503-399-2424    Fax: 503-375-7451
Rosamund M Irwin, MD
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2600 Center St Ne, Salem, OR 97301
Phone: 503-945-2800    
Jack Buchanan, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1002 Bellevue St Se, Salem Hospital Urgent Care Center, Salem, OR 97301
Phone: 503-561-5554    
Shwetha R Gurram, M.D
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 966 12th St Se Ste 130, Salem, OR 97302
Phone: 503-814-4400    
Jeanette Walker, MD
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 5560 Witzel Rd Se, Salem, OR 97317
Phone: 503-581-8251    Fax: 866-372-4073
Mark Joseph Scherlie, DO
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1275 Wallace Rd Nw, Salem, OR 97304
Phone: 503-371-3232    Fax: 503-375-2398

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