Active NPI
Steven G Black, OD
- Optometrist
- Terre Haute, IN
National Provider Identifier
1063464949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2074
- Practice address
- 4424 S 7TH St
Terre Haute, IN 47801-0218 - Phone
- (812) 299-3937
- Fax
- (812) 299-8670
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2074 | IN | Primary |
Addresses
Primary practice location
4424 S 7TH St
Terre Haute, IN 47801-0218
Mailing address
PO Box 10218
Terre Haute, IN 47801-0218
Phone (812) 299-3937
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DF9692 | Other | IN | MEDICARE RAILROAD CARRIER |
| 100251270 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4424 S 7TH St
Terre Haute, IN 47802-4304
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2074 | IN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588636800000",
"number": "1063464949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10218",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478010218",
"telephone_number": "812-299-3937",
"fax_number": "812-299-8670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4424 S 7TH ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478010218",
"telephone_number": "812-299-3937",
"fax_number": "812-299-8670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "STEVEN",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2020-05-05",
"certification_date": "2020-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "2074",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD CARRIER",
"identifier": "DF9692",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100251270",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.