Active NPI
Ellen M Black, M.D.
- Internal Medicine Physician
- Bayonne, NJ
National Provider Identifier
1164594735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MA043128
- Practice address
- 273 Avenue a
Bayonne, NJ 07002-1367 - Phone
- (201) 858-0800
- Fax
- (201) 858-3367
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MA043128 | NJ | Primary |
Addresses
Primary practice location
273 Avenue a
Bayonne, NJ 07002-1367
Mailing address
273 Avenue a
Bayonne, NJ 07002-1367
Phone (201) 858-0800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051110000050 | NJ | Practitioner - Internal Medicine | 3072531839 | Practice locations: Bayonne, NJ |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA043128 | NJ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonoview Consulting Inc. | Past | Accepting new patients |
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.
-
- Mobile Radiology Clinic/Center
- West New York, NJ
- NPI 1528203387
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital
- West Orange, NJ
- NPI 1013919620
Inpatient rehabilitation facility
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Boston University School of Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
946 Ave C
Bayonne, NJ 07002-3026
Phone (215) 858-0800
Hospital & facility affiliations
- Jersey City Medical Center
- Carepoint Health - Bayonne Medical Center
- Kessler Rehab Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164594735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "273 AVENUE A",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070021367",
"telephone_number": "201-858-0800",
"fax_number": "201-858-3367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "273 AVENUE A",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070021367",
"telephone_number": "201-858-0800",
"fax_number": "201-858-3367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "ELLEN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "MA043128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayonne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.