Douglas Scott Black, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

L0033 Issued in TX

Practice address

1002 Texas Blvd
Suite 401
Texarkana, TX 75501-5107

Phone

(903) 794-8820

Fax

(903) 794-8878

NPI assigned

Oct 20, 2005

Last updated

Nov 4, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX, AR2 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

Specialty

Internal MedicineAlso: Interventional Cardiology

Education

University of Arkansas College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Titus County Hospital DistrictGroup PAC ID 0143203257, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Titus Regional Medical Center Hospital, Mount Pleasant, TX, CCN 450080

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dblack321106@christushealth.direct-ci.net

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

• Titus County Hospital District

  dba Titus Regional Medical Center

  • Multi-Specialty Clinic/Center
  • Mount Pleasant, TX
  • NPI 1063548881
  Medicare reassignment Care Compare group NPD
• Advanced Cardiology of Texarkana PA

  dba Douglas Scott Black, MD

  • Interventional Cardiology Physician
  • Texarkana, TX
  • NPI 1548387756
  NPD Authorized official
• Permian Premier Health Services Inc

  • Contractor
  • Odessa, TX
  • NPI 1285664763

  AR

  Medicare reassignment
• Titus County Hospital District

  dba Cancer Care at Titus

  • Radiation Oncology Clinic/Center
  • Mount Pleasant, TX
  • NPI 1730876558
  NPD
• Titus County Hospital District

  dba Titus Regional Medical Center

  • General Acute Care Hospital
  • Mount Pleasant, TX
  • NPI 1174526529
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Titus County Hospital District

  dba Titus Regional Medical Center

  • Multi-Specialty Clinic/Center
  • Mount Pleasant, TX
  • NPI 1063548881

  Hospital

  Care Compare affiliation
• Titus County Hospital District

  dba Titus Regional Medical Center

  • General Acute Care Hospital
  • Mount Pleasant, TX
  • NPI 1174526529
  Care Compare affiliation

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1033108196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 TEXAS BLVD",
            "address_2": "SUITE 401",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015107",
            "telephone_number": "903-794-8820",
            "fax_number": "903-794-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 TEXAS BLVD",
            "address_2": "SUITE 401",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015107",
            "telephone_number": "903-794-8820",
            "fax_number": "903-794-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DOUGLAS",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "L0033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042154704",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100848130B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140606001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty J. Feir PH.D., P.C.
• Tashina Mariah Bevill, FNP-C
• Dandra D Bingham, MD
• Lana Bishop, PHARMD
• Jeffrey James Blaauw, ATP
• April Blackwell
• Tara Breann Blair, MOT, OTR/L
• Charles Leonard Blankenship Jr., M.D.
• Rickie Bledsoe
• Sarah Jane Blue, RPH

• Interventional Cardiology Physician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Interventional Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.