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

Jacob Wiley Blickenstaff, MD

Individual provider Anesthesiology Physician · NPI 1487038253

Jacob Wiley Blickenstaff, MD is an Anesthesiology in Honolulu, Hawaii. Graduated from University of California, Irvine, California College of Medicine in 2015, 11 years ago. Practices with Koolau Anesthesia Group LLC, a 20-clinician group and accepts Medicare assignment. Licensed in Hawaii.

Years since qualifying
11
Trained at
University of California, Irvine, California College of Medicine
Licensed in
HI
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1329 Lusitana St Ste 604
Honolulu, HI 96813-2431
Phone: (808) 531-1116
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence MD-20256 (HI)

Record details

NPI number1487038253
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 12, 2015
Last updated in NPPESJanuary 31, 2022
Certification dateJanuary 31, 2022

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolUNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Koolau Anesthesia Group Llc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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