Kenneth Todd Blackner, MD is a medicare enrolled "General Practice" physician in Shelley, Idaho. He went to University Of Utah School Of Medicine and graduated in 2005 and has 19 years of diverse experience with area of expertise as General Practice. He is a member of the group practice Bmh Inc and his current practice location is
275 W Locust St, Shelley, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 357-3960.
Kenneth Todd Blackner is licensed to practice in Idaho (license number M-11785) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1043339641.
Physician's Profile
| Full Name | Kenneth Todd Blackner |
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| Gender | Male |
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| Speciality | General Practice |
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| Experience | 19 Years |
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| Location | 275 W Locust St, Shelley, Idaho |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kenneth Todd Blackner attended and graduated from University Of Utah School Of Medicine in 2005
NPI Data:
- NPI Number: 1043339641
- Provider Enumeration Date: 03/28/2007
- Last Update Date: 02/03/2016
Medicare PECOS Information:
- PECOS PAC ID: 5395885552
- Enrollment ID: I20121227000405
Medical Identifiers
Medical identifiers for Kenneth Todd Blackner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043339641 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208D00000X | General Practice | 0101240258 (Virginia) | Secondary |
| 208D00000X | General Practice | M-11785 (Idaho) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Bmh Inc | 8426149758 | 124 |
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. Kenneth Todd Blackner allows following entities to bill medicare on his behalf.
| Entity Name | Bmh Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255539193
PECOS PAC ID: 8426149758
Enrollment ID: O20071018000897 |
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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. Kenneth Todd Blackner 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 Address | Practice Location Address |
|---|
Kenneth Todd Blackner, MD
618 E 1450 N,
Shelley, ID 83274-5078
Ph: (757) 617-3339 | Kenneth Todd Blackner, MD
275 W Locust St,
Shelley, ID 83274-1230
Ph: (208) 357-3960 |
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