Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Blake Alexander Hanson, PA-C

Individual provider Physician Assistant · NPI 1679128672

Blake Alexander Hanson, PA-C is a Physician Assistant in Tulsa, Oklahoma. Qualified in 2019, 7 years ago. Practices with St John Physicians, Inc, a 264-clinician group and accepts Medicare assignment.

Years since qualifying
7
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2000 S Wheeling Ave Ste 900
Tulsa, OK 74104-5647
Phone: (918) 403-6284
Fax: (918) 403-6323
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1679128672
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 6, 2019
Last updated in NPPESMarch 31, 2020
Certification dateMarch 31, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice St. John Physicians, Inc. — 264 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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