Melissa Ann Blackburn-Kierkla, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

200805 Issued in MA

Practice address

218 Cedar Swamp Rd
Monson, MA 01057-9307

Phone

(413) 237-3232

NPI assigned

Jun 5, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA, CT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Impact Health PCGroup PAC ID 0941562664, 79 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.46 of 100Reported as group

Quality

61.91

Promoting interoperability

81

Improvement activities

40

Cost

65.46

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: melissa.blackburn-kierkla.1@11991.direct.athenahealth.com
• Direct secure messaging: mercy.life.of.massachusetts@trinityhealth.ma.medicity.net
• FHIR API: https://api.platform.athenahealth.com/11991/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MK-Urology LLC

  • Nurse Practitioner
  • Monson, MA
  • NPI 1871039024

  CT

  Medicare reassignment NPD Authorized official
• Impact Health P.C.

  • Nurse Practitioner
  • Orange, CT
  • NPI 1730694316

  MA

  Medicare reassignment Care Compare group NPD
• CH Specialty Services Ma PC

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1902510720
  Medicare reassignment NPD
• Paradigm Healthcare, PC

  • Family Medicine Physician
  • Leeds, MA
  • NPI 1932575974
  Medicare reassignment NPD
• Hampden County Physician Associates, LLC

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1992794770
  NPD (past)
• Hampden County Physician Associates, LLC.

  • Sleep Medicine (Internal Medicine) Physician
  • Southwick, MA
  • NPI 1548567696
  NPD (past)
• Monson Pediatrics PC

  • Family Medicine Physician
  • Monson, MA
  • NPI 1790987345
  NPD (past)
• The Mercy Hospital Inc

  dba Providence Behavioral Health Hospital

  • Psychiatric Hospital
  • Holyoke, MA
  • NPI 1629062906
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1164461273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 CEDAR SWAMP RD",
            "city": "MONSON",
            "state": "MA",
            "postal_code": "010579307",
            "telephone_number": "413-237-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 CEDAR SWAMP RD",
            "city": "MONSON",
            "state": "MA",
            "postal_code": "010579307",
            "telephone_number": "413-237-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN-KIERKLA",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "200805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mercy.life.of.massachusetts@trinityhealth.ma.medicity.net",
            "affiliation": "N",
            "endpointDescription": "trinity health mercy life pace holyoke",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "218 Cedar Swamp Rd",
            "city": "Monson",
            "state": "MA",
            "country_code": "US",
            "postal_code": "010579307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrews Vision Care LLC
• James Andrews IV, OD
• Deborah Avery, HIS
• Damianos G Avramidis, PHARMD
• Be a Monarch
• Holly Elaine Boulanger, R.N.
• Melanie Brassard, BCBA
• Amy Breton, NBC-HWC
• Lori Mary Chamberlain
• David Coderre, RPH

• Pediatric Nurse Practitioner in Monson, MA
• Providers in Monson, MA by specialty
• Pediatric Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.