Jennifer Michelle Black, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A84075 Issued in CA

Practice address

1000 Vale Terrace Dr
Vista, CA 92084-5218

Phone

(760) 631-5000

NPI assigned

Jun 2, 2006

Last updated

Sep 28, 2021By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Internal Medicine

Education

University of Wisconsin School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.black@168064768409604.direct.elationemr.com

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.

• Monica Perlman MD Inc.

  dba Perlman Clinic

  • Primary Care Clinic/Center
  • La Jolla, CA
  • NPI 1134309305

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Form Health Associates, P.C.

  • Endocrinology, Diabetes & Metabolism Physician
  • Bakersfield, CA
  • NPI 1043835044
  NPD
• Form Health Associates, P.C.

  • Endocrinology, Diabetes & Metabolism Physician
  • Bakersfield, CA
  • NPI 1801615752
  NPD (past)
• Regents of the University of California

  dba Ucsd Medical Center Pharmacy

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• UC San Diego Health - Rancho Family Medical Group

  • Multi-Specialty Clinic/Center
  • Temecula, CA
  • NPI 1003385071
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1194763326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE A200",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241350",
            "telephone_number": "858-766-6007",
            "fax_number": "858-900-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "43773-020",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "43773-020",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A84075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34469600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark S. Bibler, M.D.
• Bio-Medical Applications of California, Inc. (FMC DIALYSIS SERVICES Buena Creek)
• Jesse Bittle, C.PED
• Alexis Zipporrah Bituin-Harris
• Michele Bjornson, NP
• Allison Blaha, C.PED
• Brian Chris Blalock, D.D.S., M.D.
• Christina Blanchard, MS, RD
• Veronica Blanco
• Alicia Blanton

• Internal Medicine Physician in Vista, CA
• Providers in Vista, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.