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

Mr. Brett W. Blickenstaff, PA

Individual provider Physician Assistant · NPI 1629479035

Mr. Brett W. Blickenstaff, PA is a Physician Assistant in Troy, Michigan. Qualified in 2014, 12 years ago. Practices with Beaumont Medical Group- Specialty Services, a 858-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
12
Licensed in
MI
In the registry since
2014
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

44201 Dequindre Rd
Troy, MI 48085-1117
Phone: (248) 964-8912
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601007095 (MI)

Record details

NPI number1629479035
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 5, 2014
Last updated in NPPESJuly 22, 2022
Certification dateJuly 22, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Beaumont Medical Group- Specialty Services — 858 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Troy