Tina Marie Blackley, APRN FNP-C in Bangor, ME

Tina Marie Blackley, APRN FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Bangor, Maine. Her current practice location is 900 Broadway, Bangor, Maine. You can reach out to her office (for appointments etc.) via phone at (207) 907-3300.

Tina Marie Blackley is licensed to practice in Maine (license number CNP171038) 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 1962937417.

Contact Information

	Tina Marie Blackley, APRN FNP-C
	900 Broadway, Bangor, ME 04401
	(207) 907-3300
	(207) 907-1923

Map and Direction

Provider's Profile

Full Name	Tina Marie Blackley
Gender	Female
Speciality	Nurse Practitioner - Family
Location	900 Broadway, Bangor, Maine
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962937417
Provider Enumeration Date: 04/21/2017
Last Update Date: 12/06/2019

Medicare PECOS Information:

PECOS PAC ID: 6305103805
Enrollment ID: I20171207001719

Medical Identifiers

Medical identifiers for Tina Marie Blackley such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962937417	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	CNP171038 (Maine)	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. Tina Marie Blackley allows following entities to bill medicare on her behalf.

Entity Name	Eastern Maine Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790789147 PECOS PAC ID: 2062315161 Enrollment ID: O20040128000088

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. Tina Marie Blackley 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
Tina Marie Blackley, APRN FNP-C C/o St Marys Health System - Provider Enrollment, Po Box 7291, Lewiston, ME 04243-7291 Ph: (207) 777-8560	Tina Marie Blackley, APRN FNP-C 900 Broadway, Bangor, ME 04401 Ph: (207) 907-3300

Reviews and Comments

Nurse Practitioner Nurses in Bangor, ME

Diane M Hill, MSN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Northeast Dr, Bangor, ME 04401 Phone: 207-275-3800 Fax: 207-275-3803
Nancy J Fishwick, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 30 Mckinley St, Bangor, ME 04401 Phone: 207-659-3690
Kathrin G Hastey, FNPC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6 Telcom Dr, Bangor, ME 04401 Phone: 207-947-0147 Fax: 207-990-3365
Judy Splittgerber, PMHNP-BC, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6 Telcom Dr Fl 2, Bangor, ME 04401 Phone: 207-947-0147
Ms. Constance E Russell, FNPC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 268 Stillwater Avenue, Acadia Hospital Corp, Bangor, ME 04401 Phone: 207-973-6100 Fax: 207-973-6109
Maegan L Woodman, FNPC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6 Telcom Dr Fl 2, Bangor, ME 04401 Phone: 207-947-0147 Fax: 207-990-3365
Mrs. Alexandria Elizabeth Redmond, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 302 Husson Ave, #2, Bangor, ME 04401 Phone: 207-941-2373 Fax: 207-941-8803

Tina Marie Blackley, APRN FNP-C - Medicare Nurse Practitioner in Bangor, ME