Jonathan R Black, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8145 Issued in FL

Practice address

2290 NW 2ND Ave
Suite 7
Boca Raton, FL 33431-7457

Phone

(561) 706-1004

NPI assigned

Nov 16, 2010

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Senior Living Memory Health IncGroup PAC ID 7517480577, 113 clinicians

Ezr ResearchGroup PAC ID 0547787434, 10 clinicians

Palm Beach Psychology Group, LLCGroup PAC ID 6709009756, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ezr Research

  dba Espinosa Neuroscience Institute

  • Medical Specialty Clinic/Center
  • Boca Raton, FL
  • NPI 1225853617
  Medicare reassignment Care Compare group NPD
• Palm Beach Psychology Group, LLC

  • Clinical Psychologist
  • Boca Raton, FL
  • NPI 1487085809
  Medicare reassignment Care Compare group NPD
• Senior Living Memory Health, Inc.

  dba Memory Training Centers of Florida

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1851847834
  Medicare reassignment Care Compare group NPD
• Mtca Psychological Services P.a.

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1740552322
  Medicare reassignment NPD
• Neuroscience Consultants LLP

  • Specialist
  • Medley, FL
  • NPI 1346217452
  Medicare reassignment NPD
• Pediatric Behavioral Health Associates, Inc.

  dba Pediatric Behavioral Health Associates of Marion County

  • Clinical Social Worker
  • Belleview, FL
  • NPI 1861953523
  NPD (past)
• Seal Therapeutic Corporation

  • Mental Health Counselor
  • Belleview, FL
  • NPI 1346408721
  NPD (past)

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1144521501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7546 OAKBORO DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677504",
            "telephone_number": "954-629-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 NW 2ND AVE",
            "address_2": "SUITE 7",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317457",
            "telephone_number": "561-706-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JONATHAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-16",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francesca Bitondo
• Mario Biundo
• Melanie Bivins, APRN, FNP-BC
• Emmalyn Hope Bizub
• Jason Daniel Bjalme, DPT
• Blackbird Pharmacy, LLC
• Max Blackburn, PT, DPT
• Jennifer Ann Blacklock, PSY.D.
• Leslie Blackman, MA CCC, SLP
• Danielle Marie Blackwell

• Clinical Psychologist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.