David Martin Black, M.D.

Key facts

NPI

1487918280

Entity type

Individual (NPI type 1)

Primary specialty

Emergency Medicine Physician 207P00000X

License

4301101004 (MI)

Practice address

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Phone

(734) 995-3764

NPI assigned

Jun 27, 2012

Sex

Male

Sole proprietor

Yes

Organizations & group practices 7

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.

• Epmg of Michigan, P.C. Emergency Medicine Physician · Livonia, MI · NPI 1386688992
  Medicare reassignment Care Compare group NPD EMERGENCY MEDICINE · MI
• Iha Health Services Corporation Obstetrics & Gynecology Physician · Canton, MI · NPI 1457408965
  Medicare reassignment NPD MI
• Sparrow Ionia Hospital Critical Access Hospital · Ionia, MI · NPI 1700820065
  Medicare reassignment NPD MI
• Iha Health Service Corporation Obstetrics & Gynecology Physician · Ypsilanti, MI · NPI 1831053701
  NPD
• Iha Health Services Corporation Urgent Care Clinic/Center · Ann Arbor, MI · NPI 1992937023
  NPD
• Sparrow Ionia Hospital Family Medicine Physician · Ionia, MI · NPI 1033271143
  NPD
• Sparrow Ionia Hospital Emergency Medicine Physician · Ionia, MI · NPI 1588747075
  NPD EMERGENCY MEDICINE

Hospital & facility affiliations 2

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

• Saint Joseph Mercy Livingston Hospital General Acute Care Hospital · Brighton, MI · NPI 1093748642
  Care Compare affiliation Hospital
• St Joseph Mercy Hospital General Acute Care Hospital · Ypsilanti, MI · NPI 1780658443
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Emergency Medicine

Education

Emory University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epmg of Michigan PC (108 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital · Ann Arbor, MI · CCN 230156
• Trinity Health Livingston Hospital Hospital · Howell, MI · CCN 230069

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 21, 2021.

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1487918280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 GREEN RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051511",
            "telephone_number": "734-995-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 MCAULEY DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-995-3764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Byron Rd",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "MI",
            "postal_code": "488431002",
            "country_code": "US",
            "telephone_number": "734-995-3764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DAVID",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301101004",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301101004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dblack23998@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Saint Joseph Mercy Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "5301 McAuley Dr",
            "city": "Ypsilanti",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481971051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ypsilanti, MI

• Bio-Medical Applications of Michigan, Inc.
• Lauren Birks, LMSW
• Casey Bishop
• Jade Bishop, LLMSW
• Richard Alfred Bishop, PHARMACIST
• Nicole Black, CRNA
• Jennifer Diane Blackburn, MSW
• Sean Joseph Novara Blackburn, MD
• Alexander Blank
• Julie Blasko, MA, CCC-SLP, CBIS

All providers in Ypsilanti, MI · Emergency Medicine Physician in Michigan