Michelle M. Black, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP011489 Issued in PA

Practice address

120 Radnor Rd Ste 100
State College, PA 16801

Phone

(814) 231-7868

Fax

(814) 238-4169

NPI assigned

Jul 20, 2011

Last updated

Aug 7, 2018By the provider in NPPES

Sex

Female

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 PA

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

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Nittany Medical Center Health Services IncGroup PAC ID 8426136797, 366 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Nittany Medical Center Hospital, State College, PA, CCN 390268

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Mount Nittany Medical Center Health Services Inc

  dba Mount Nittany Physician Group

  • Internal Medicine Physician
  • State College, PA
  • NPI 1598992554
  Medicare reassignment Care Compare group NPD
• Mount Nittany Medical Center Health Services Inc

  • Pain Clinic/Center
  • State College, PA
  • NPI 1407035553
  NPD (past)

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

• Mount Nittany Medical Center

  dba Mount Nittany Pain Center

  • Pain Clinic/Center
  • State College, PA
  • NPI 1104991801

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • Clinic/Center
  • State College, PA
  • NPI 1194521302

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • General Acute Care Hospital
  • State College, PA
  • NPI 1730173154
  Care Compare affiliation
• Mount Nittany Medical Center

  dba Mount Nittany Surgical Center

  • Ambulatory Surgical Clinic/Center
  • State College, PA
  • NPI 1780750620

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • Ambulatory Surgical Clinic/Center
  • State College, PA
  • NPI 1780752378

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1083902316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 RADNOR RD STE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017970",
            "telephone_number": "814-231-7868",
            "fax_number": "814-238-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RADNOR RD STE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "16801",
            "telephone_number": "814-231-7868",
            "fax_number": "814-238-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MICHELLE",
        "middle_name": "M.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP011489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory G Billy, MD
• Jacqueline Nicole Bilski, LAPC
• Bio-Medical Applications of Pennsylvania, Inc. (FMC Dialysis Services State College)
• Eleanor Ruth Bird, RPH
• Dylan Scott Bisel, PT
• Andrew C Blender, O.D.
• Constance L Bliss, D.C.
• Cristina B Bloom, MSW, LSW
• Blue & White Counseling LLC
• Ashton Boal, PSY.D.

• Adult Health Nurse Practitioner in State College, PA
• Providers in State College, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.