Jessica Elizabeth Blacknik
Individual provider Active NPI Physician Assistant · Hazlet, NJ
NPI 1033980255 · NPPES record last updated Jun 4, 2026
Key facts
- NPI
- 1033980255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 10 Janine PL
Hazlet, NJ 07730-1114 - Phone
- (732) 609-4157
- NPI assigned
- Jan 16, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Tampa General Cir
Tampa, FL 33606-3571
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | FL | Yes |
Addresses
Primary practice location
10 Janine PL
Hazlet, NJ 07730-1114
Mailing address
10 Janine PL
Hazlet, NJ 07730-1114
Phone (732) 609-4157
Other providers in Hazlet, NJ
- Elizabeth Bergen
- Kristen Bertinelli
- Glenn Betancourt
- Ori Biala
- Sinnamon Bilach
- Victoria Ann Bleich
- Blue Ocean Care
- Blue Star Mental Health Services
- Blue Star Recovery
- George Blumetti
All providers in Hazlet, NJ · Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.