Daniel Alexander Black, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO3782 Issued in FL

Practice address

113 Nature Walk Pkwy
Unit 105
Saint Augustine, FL 32092-3066

Phone

(315) 382-5910

NPI assigned

Jul 24, 2013

Last updated

Oct 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent's St Johns County Hospital, St. Johns, FL, CCN 100361
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• St. Johns Podiatry & Wound Care Specialists LLC

  • Foot & Ankle Surgery Podiatrist
  • St Augustine, FL
  • NPI 1801568431
  Medicare reassignment NPD Authorized official
• Daniel a Black DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Fort Myers, FL
  • NPI 1063940211
  NPD

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

• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation
• St Vincents Health System Inc

  dba Ascension St Vincent's St. Johns County

  • General Acute Care Hospital
  • Saint Johns, FL
  • NPI 1861078651
  Care Compare affiliation

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1407298987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 NATURE WALK PKWY",
            "address_2": "UNIT 105",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923066",
            "telephone_number": "315-382-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 NATURE WALK PKWY",
            "address_2": "UNIT 105",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923066",
            "telephone_number": "315-382-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DANIEL",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-24",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PO3782",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Birrell, LMSW
• Melinda Bisenius, M.A., CCC-SLP
• Barbara Marie Bish, PHARMD, CRPH
• Samy Farid Bishai, M.D
• Lisa Reisdorf Bishop
• Lindsey Black
• Sarah Rose Blackwelder
• Blade and Bridge Healthcare PLLC
• Melanie Blair, SLP
• Romeo Blanchette II, PHARMD

• Foot & Ankle Surgery Podiatrist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

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