Stephanie Elizabeth Blackmore, FNP in Surprise, AZ

Stephanie Elizabeth Blackmore, FNP is a medicare enrolled "Nurse Practitioner - Family" in Surprise, Arizona. Her current practice location is 14961 W Bell Rd Ste 100, Surprise, Arizona. You can reach out to her office (for appointments etc.) via phone at (623) 439-5176.

Stephanie Elizabeth Blackmore is licensed to practice in Arizona (license number 245687) 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 1366052771.

Contact Information

	Stephanie Elizabeth Blackmore, FNP
	14961 W Bell Rd Ste 100, Surprise, AZ 85374-3203
	(623) 439-5176
	(855) 583-1420

Map and Direction

Provider's Profile

Full Name	Stephanie Elizabeth Blackmore
Gender	Female
Speciality	Nurse Practitioner - Family
Location	14961 W Bell Rd Ste 100, Surprise, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1366052771
Provider Enumeration Date: 07/31/2020
Last Update Date: 10/10/2023

Medicare PECOS Information:

PECOS PAC ID: 3072938117
Enrollment ID: I20211118002824

Medical Identifiers

Medical identifiers for Stephanie Elizabeth Blackmore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366052771	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	245687 (Arizona)	Primary
363LP2300X	Nurse Practitioner - Primary Care	245687 (Arizona)	Secondary

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. Stephanie Elizabeth Blackmore allows following entities to bill medicare on her behalf.

Entity Name	Maria Gonzalez Berlari Md Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1699025981 PECOS PAC ID: 2769625854 Enrollment ID: O20130820001092

Entity Name	Healthful Healthcare Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811603202 PECOS PAC ID: 8325410830 Enrollment ID: O20230209002703

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. Stephanie Elizabeth Blackmore 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 Address	Practice Location Address
Stephanie Elizabeth Blackmore, FNP 14961 W Bell Rd Ste 100, Surprise, AZ 85374-3203 Ph: (623) 439-5176	Stephanie Elizabeth Blackmore, FNP 14961 W Bell Rd Ste 100, Surprise, AZ 85374-3203 Ph: (623) 439-5176

Reviews and Comments

Nurse Practitioner Nurses in Surprise, AZ

Celine Tubillara Villariz, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14973 W Bell Rd Ste 100, Surprise, AZ 85374 Phone: 623-934-1245 Fax: 623-934-3598
Robert Wolfe, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 18761 N Reems Rd Ste 400, Surprise, AZ 85374 Phone: 623-583-9180
Herlinda C Castro, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15351 W Bell Rd, Surprise, AZ 85374 Phone: 877-809-5092
Zofia Wilk, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13945 W Grand Ave Ste 105, Surprise, AZ 85374 Phone: 623-546-0007
Paige Leykam, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 14780 W Mountain View Blvd Ste 211, Surprise, AZ 85374 Phone: 480-428-7678 Fax: 480-569-2708
Marisa Stapleton, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 17751 W Villa Chula Ln, Surprise, AZ 85387 Phone: 909-938-9527
Catherine Lisondra Krings, MSN,FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 13945 W Grand Ave Ste A-105, Surprise, AZ 85374 Phone: 623-546-0007 Fax: 623-584-6915

Stephanie Elizabeth Blackmore, FNP - Medicare Nurse Practitioner in Surprise, AZ