Michael Edward Black

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1707 Riggins Rd
Tallahassee, FL 32308-5317

Phone

(850) 877-4134

Fax

(850) 942-4112

NPI assigned

Jun 2, 2025

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

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatology Associates of Tallahassee PA

  • Dermatology Physician
  • Tallahassee, FL
  • NPI 1295842672
  Medicare reassignment NPD
• Florida Medical Practice Plan Inc

  • General Practice Physician
  • Tallahassee, FL
  • NPI 1326386293
  NPD
• Dermatology Associates of Tallahassee, PA

  • Dermatology Physician
  • Valdosta, GA
  • NPI 1730567504
  NPD

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1043103674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13834",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323173834",
            "telephone_number": "850-205-6232",
            "fax_number": "855-975-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 RIGGINS RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085317",
            "telephone_number": "850-877-4134",
            "fax_number": "850-942-4112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3009 4th St",
            "address_purpose": "LOCATION",
            "city": "Marianna",
            "state": "FL",
            "postal_code": "324462122",
            "country_code": "US",
            "telephone_number": "850-526-7474",
            "fax_number": "850-526-2148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-02",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Joseph Bisson
• Jeffrey Bivins, DC
• Donna J Bixler, ARNP-C
• Herman Black
• Jamison Black
• Johnnie Blackburn
• Maggie Blackburn, MAGGIE BLACKBURN MD
• Richard E Blackburn, M.D.
• Sarah Elizabeth Blackburn
• Tricia Blackburn

• Physician Assistant in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; 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.