Melanie Russell Blackstock, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

71405 Issued in MA

Practice address

109 Commercial St
Malden, MA 02148-5509

Phone

(781) 388-4160

Fax

(781) 397-8715

NPI assigned

May 11, 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

Medicare fee-for-service enrollment

Enrolled in OK, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Boca Raton, FL
  • NPI 1710647334

  FL, Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• DHP of Manatee PA

  • Obstetrics & Gynecology Physician
  • Mangonia Park, FL
  • NPI 1134771611

  FL, Obstetrics & Gynecology

  Medicare reassignment NPD
• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Melbourne, FL
  • NPI 1245472661

  Obstetrics & Gynecology

  NPD
• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Winter Haven, FL
  • NPI 1851282016

  Obstetrics & Gynecology

  NPD
• Melanie R. Blackstock, M.D., Inc.

  • Obstetrics & Gynecology Physician
  • Tulsa, OK
  • NPI 1821162512

  Obstetrics & Gynecology

  NPD (past)

Specialty

Obstetrics/Gynecology

Education

University of Oklahoma College of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

OB Hospitalist Group LLC 127 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1477503571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 COMMERCIAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485509",
            "telephone_number": "781-388-4160",
            "fax_number": "781-397-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 COMMERCIAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485509",
            "telephone_number": "781-388-4160",
            "fax_number": "781-397-8715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Commercial St",
            "address_purpose": "LOCATION",
            "city": "Malden",
            "state": "MA",
            "postal_code": "021485509",
            "country_code": "US",
            "telephone_number": "781-388-4160",
            "fax_number": "781-397-8715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKSTOCK",
        "first_name": "MELANIE",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "71405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Lenise Bickerstaff
• Hannah Biederman
• Merry Jo Binkley, RN
• Emilie Petula Tibemen Biondokin, M.D.
• Laxman Bishwakarma
• Michael Blake
• Arnold J. Blank, MD
• Elana Bloomfield, MD
• Deanna Boden-Yu, LMHC
• Heather Bogrett, RN

• All providers in Malden, MA
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.