Ms Maryellen Blank, NP - Medicare Nurse Practitioner in Bay Shore, NY

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Ms Maryellen Blank, NP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Bay Shore, New York. Her current practice location is 21 4th Ave, Bay Shore, New York. You can reach out to her office (for appointments etc.) via phone at (631) 665-6707.

Ms Maryellen Blank is licensed to practice in New York (license number F400620-01) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1609930015.

Contact Information

Ms Maryellen Blank, NP
21 4th Ave,
Bay Shore, NY 11706-7908
(631) 665-6707
(631) 665-3564

Map and Direction




Provider's Profile

Full NameMs Maryellen Blank
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location21 4th Ave, Bay Shore, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1609930015
  • Provider Enumeration Date: 12/20/2006
  • Last Update Date: 10/17/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1759609688
  • Enrollment ID: I20150406000602

Medical Identifiers

Medical identifiers for Ms Maryellen Blank such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1609930015NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
364SP0809XClinical Nurse Specialist - Psychiatric/mental Health, Adult 400620 (New York)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health F400620-01 (New York)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Maryellen Blank allows following entities to bill medicare on her behalf.
Entity NameCatholic Charities Of The Diocese Of Rockville Centre
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124034558
PECOS PAC ID: 9436137908
Enrollment ID: O20040721000332
Entity NameThe Long Island Home
Entity TypePart B Supplier - Hospital Department(s)
Entity IdentifiersNPI Number: 1821394016
PECOS PAC ID: 8224055108
Enrollment ID: O20110411000230

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Maryellen Blank is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Maryellen Blank, NP
170 Driftwood Dr,
West Islip, NY 11795-5002

Ph: (631) 422-7362		Ms Maryellen Blank, NP
21 4th Ave,
Bay Shore, NY 11706-7908

Ph: (631) 665-6707

Reviews and Comments


Nurse Practitioner Nurses in Bay Shore, NY

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Allison Marie Kornahrens, PMHNP
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Marie Burkhardt, N.P.
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Phone: 631-968-3818    Fax: 631-968-3698
Deborah Beauplan,
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Susan Aiken, NPP
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Practice Location: 9 4th Ave, Bay Shore, NY 11706
Phone: 631-665-6707    
Ms. Iverine M Anderson, NP
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Medicare: Medicare Enrolled
Practice Location: 24 Princeton Street, Bay Shore, NY 11706
Phone: 516-680-6653    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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