Active NPI
Mindy A Black, M.D.
- Otolaryngology Physician
- Tucson, AZ
National Provider Identifier
1295065639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 41876
- Practice address
- 1501 N Campbell Ave
Tucson, AZ 85724-0001 - Phone
- (520) 694-8888
- NPI assigned
- Jan 7, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 41876 | AZ | Primary |
Addresses
Primary practice location
1501 N Campbell Ave
Tucson, AZ 85724-0001
Mailing address
2701 E Elvira Rd
Tucson, AZ 85756-7124
Phone (520) 694-8888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41876 | AZ | MD | Otolaryngology Physician |
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.
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1508809427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1295065639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 E ELVIRA RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857567124",
"telephone_number": "520-694-8888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 N CAMPBELL AVE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857240001",
"telephone_number": "520-694-8888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "MINDY",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-07",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "AZ",
"license": "41876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.