MISS STACEY MELISSA BLACKMAN (APN) – Primary Care Nurse Practitioner, NPI 1366760373

MISS STACEY MELISSA BLACKMAN (APN) is a healthcare provider. based in East orange, New Jersey. specializing in NURSE PRACTITIONER. They hold the professional credentials APN. They hold a License No. 26NJ00286100 (NJ). The NPI Number for MISS STACEY MELISSA BLACKMAN (APN) is 1366760373

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
MISS STACEY MELISSA BLACKMAN (APN)
NPI
1366760373
Phone
(201) 341-8190
Address
9 WAYNE AVE
Enumeration Date
14 May 2010
Last Update Date
25 July 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2127346621
Graduation Year
2008 (18 years ago)
PAC ID
9234479668
Group Practice PAC ID
6608305156
Professional Enrollment ID
I20190322000102
Address ID
NJ070091023CE25XXXRDXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:16State licenses:1Digital endpointsOther names

7,515 NURSE PRACTITIONER in NJ

Provider Addresses for MISS STACEY MELISSA BLACKMAN (APN)

  • 9 WAYNE AVE

    EAST ORANGE, NJ 070181907

    Phone: (201) 341-8190

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-03-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190322000102INurse PractitionerNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99283Emergency department visit with low level of medical decision making1212$0
View full utilization report →

Insurance plans in this area (ZIP 07018)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6608305156View full group profile
NameSpecialtyState
Emergency MedicineFL
Nurse PractitionerTX
Nurse PractitionerNY
Nurse PractitionerKY
Nurse PractitionerNJ
Nurse PractitionerNJ
Nurse PractitionerNY
Nurse PractitionerFL
Physician AssistantCA
Nurse PractitionerFL

Reviews

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Frequently asked questions

What NPI should I save for MISS STACEY MELISSA BLACKMAN (APN)?
Save NPI 1366760373 if you need a stable reference for MISS STACEY MELISSA BLACKMAN (APN).
Is MISS STACEY MELISSA BLACKMAN (APN) active in the national directory?
MISS STACEY MELISSA BLACKMAN (APN)'s public NPI profile is in an active state.
What does MISS STACEY MELISSA BLACKMAN (APN) treat or focus on?
Patients typically see MISS STACEY MELISSA BLACKMAN (APN) under the specialty Primary Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MISS STACEY MELISSA BLACKMAN (APN)'s primary listing?
We display East Orange, New Jersey because that is what the record indicates for MISS STACEY MELISSA BLACKMAN (APN).
Is MISS STACEY MELISSA BLACKMAN (APN) a real provider?
This page reflects official NPPES data for NPI 1366760373. Always confirm identity and privileges with the practice and licensing boards.

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