Individual provider Active NPI

David Martin Black, M.D.

  • Emergency Medicine Physician
  • Ypsilanti, MI
National Provider Identifier
1487918280
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301101004 Issued in MI
Practice address
5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone
(734) 995-3764
NPI assigned
Jun 27, 2012
Last updated
Dec 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301101004 MI
Emergency Medicine Physician 207P00000X 4301101004 MI Primary

Addresses

Primary practice location

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Mailing address

3000 Green Rd
Ann Arbor, MI 48105-1511
Phone (734) 995-3764

Other practice location 1

620 Byron Rd
Howell, MI 48843-1002
Phone (734) 995-3764

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dblack23998@direct.trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20150604001234 MI Practitioner - Emergency Medicine 7416106406 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
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 PCGroup PAC ID 4789596339, 108 clinicians

Practice addresses (Care Compare)

5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital CurrentSince Sep 1, 2017 Accepting new patients
Epmg of Michigan, P.C. Emergency Medicine CurrentSince Sep 15, 2015 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Sparrow Ionia Hospital Emergency Medicine CurrentSince Sep 1, 2017 Accepting new patients
Sparrow Ionia Hospital Current Accepting new patients
Iha Health Service Corporation CurrentSince Jun 1, 2015 Accepting new patients
Iha Health Services Corporation CurrentSince Jun 1, 2015 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

4200 Whitehall Dr
Ste 150
Ann Arbor, MI 48105
Phone (734) 995-0308

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

274 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5400

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

3565 S State Rd
Ionia, MI 48846
Phone (616) 523-1355

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

916 Myrtle St
Sturgis, MI 49091
Phone (269) 651-7824

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Interoperability endpoints

  • Direct secure messaging: dblack23998@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "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

Sources for this page

Verify at the official NPI Registry.