Individual provider Active NPI

Andrew C Black, M.D.

  • Ophthalmology Physician
  • Baton Rouge, LA
National Provider Identifier
1043417751
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD.203115 Issued in LA
Practice address
5220 Flanders Dr
Baton Rouge, LA 70808-9112
Phone
(225) 766-3437
Fax
(225) 766-3443
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A93573 CA
Ophthalmology Physician 207W00000X 2008-00586 NC
Ophthalmology Physician 207W00000X MD.203115 LA Primary

Addresses

Primary practice location

5220 Flanders Dr
Baton Rouge, LA 70808-9112

Mailing address

5220 Flanders Dr
Baton Rouge, LA 70808-9112
Phone (225) 766-3437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090805000619 LA Practitioner - Ophthalmology 1254402894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in New Orleans, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Eye Care Center LLCGroup PAC ID 4385724558, 2 clinicians

Practice addresses (Care Compare)

5220 Flanders Dr
Baton Rouge, LA 70808-9112
Phone (225) 766-3437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A93573CAMDOphthalmology Physician
MD.203115LAMDOphthalmology Physician
2008-00586NCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Eye Care Center LLC Ophthalmology CurrentSince Aug 1, 2009 Accepting new patients

Locations

5220 Flanders Dr
Baton Rouge, LA 70808
Phone (225) 766-3437

5220 Flanders Dr
Ste B
Baton Rouge, LA 70808

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1043417751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 FLANDERS DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089112",
            "telephone_number": "225-766-3437",
            "fax_number": "225-766-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 FLANDERS DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089112",
            "telephone_number": "225-766-3437",
            "fax_number": "225-766-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ANDREW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A93573",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2008-00586",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "MD.203115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.