Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Michael Lowell Blackburn, PA-C

Individual provider Surgical Physician Assistant · NPI 1639134679

Mr. Michael Lowell Blackburn, PA-C is a Physician Assistant in Lexington, Kentucky. Qualified in 2005, 21 years ago. Practices with Bluegrass Orthopaedics PSC, a 61-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
21
Licensed in
KY
In the registry since
2006
Specialties on file
2
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

3480 Yorkshire Medical Park
Lexington, KY 40509-1886
Phone: (859) 263-5140
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA934 (KY)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA934 (KY)

Record details

NPI number1639134679
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 20, 2006
Last updated in NPPESDecember 31, 2019
Certification dateDecember 31, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Bluegrass Orthopaedics Psc — 61 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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