Traci Leigh Blake, DNP,ACNPC-AG, CRNFA - Medicare Nurse Practitioner in Rockford, IL

  1. Home
  2. Nurse Practitioner
  3. IL
  4. Rockford
Traci Leigh Blake, DNP,ACNPC-AG, CRNFA is a medicare enrolled "Nurse Practitioner - Acute Care" in Rockford, Illinois. Her current practice location is 8201 E Riverside Blvd, Rockford, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 971-7000.

Traci Leigh Blake is licensed to practice in Illinois (license number 209032163) 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 1649543042.

Contact Information

Traci Leigh Blake, DNP,ACNPC-AG, CRNFA
8201 E Riverside Blvd,
Rockford, IL 61114-2300
(815) 971-7000
Not Available

Map and Direction




Provider's Profile

Full NameTraci Leigh Blake
GenderFemale
SpecialityNurse Practitioner - Acute Care
Location8201 E Riverside Blvd, Rockford, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1649543042
  • Provider Enumeration Date: 02/15/2012
  • Last Update Date: 05/01/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 2163940206
  • Enrollment ID: I20250513002155

Medical Identifiers

Medical identifiers for Traci Leigh Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1649543042NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WR0006XRegistered Nurse - Registered Nurse First Assistant 041336983 (Illinois)Secondary
363LA2100XNurse Practitioner - Acute Care 209032163 (Illinois)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. Traci Leigh Blake allows following entities to bill medicare on her behalf.
Entity NameRockford Health Physicians
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043242886
PECOS PAC ID: 2567374036
Enrollment ID: O20031103000584
Entity NameMercy Health System Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598718603
PECOS PAC ID: 7416860440
Enrollment ID: O20031111000307

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. Traci Leigh Blake 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 AddressPractice Location Address
Traci Leigh Blake, DNP,ACNPC-AG, CRNFA
2563 W Creedy Rd # 1,
Beloit, WI 53511-8707

Ph: () -		Traci Leigh Blake, DNP,ACNPC-AG, CRNFA
8201 E Riverside Blvd,
Rockford, IL 61114-2300

Ph: (815) 971-7000

Reviews and Comments


Nurse Practitioner Nurses in Rockford, IL

Misty Lynn Dehaven, APN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1639 N Alpine Rd Ste 260, Rockford, IL 61107
Phone: 815-395-1500    Fax: 815-395-1415
Mariola U Grzeszczyk, APRN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 5875 E Riverside Blvd, Rockford, IL 61114
Phone: 815-398-9491    Fax: 815-381-7498
Candice Vicencio, DNP, FNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 4215 Newburg Rd, Rockford, IL 61108
Phone: 815-988-8500    Fax: 815-977-5956
Caryn Ann Ruzic, APRN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1200 W State St, Rockford, IL 61102
Phone: 815-490-1600    Fax: 815-490-1881
Tyler James Rafferty, FNP-BC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 5666 E State St, Rockford, IL 61108
Phone: 815-226-2000    
Valerie Kae Wright, APRN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 3259 Montlake Dr, Rockford, IL 61114
Phone: 815-238-6833    
Angela Giardono, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 5666 E State St, Rockford, IL 61108
Phone: 815-226-2000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.