Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Scott Alan Blickensderfer, DO

Individual provider Urology Physician · NPI 1578568572

Dr. Scott Alan Blickensderfer, DO is an Urology in South Bend, Indiana. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 1987, 39 years ago. Practices with The South Bend Clinic LLC, a 170-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
39
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
IN
In the registry since
2005
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

6301 University Commons Ste 350
South Bend, IN 46635-1571
Phone: (574) 234-4100
Fax: (574) 282-1739
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 02001398A (IN)

Record details

NPI number1578568572
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 16, 2005
Last updated in NPPESMarch 6, 2014
Mailing address6301 University Commons, Ste 230, South Bend, IN 46635-1571

Medicare enrollment

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

Medicare specialtyUROLOGY
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 1987 (39 years in practice)
Group practice The South Bend Clinic Llc — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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