Susan Ann Black, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

29718 Issued in CO

Practice address

1504 Galena St
Aurora, CO 80010-2219

Phone

(303) 617-2300

NPI assigned

Dec 22, 2006

Sex

Female

Sole proprietor

No

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 CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Aurora Comprehensive Community Mental Health Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Aurora, CO
  • NPI 1134149057
  Medicare reassignment NPD
• Aurora Comprehensive Community Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Aurora, CO
  • NPI 1407699473
  NPD

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1497810386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 CHAMBERS RD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800117117",
            "telephone_number": "303-617-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 GALENA ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800102219",
            "telephone_number": "303-617-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61 W Davies Ave N",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801205252",
            "country_code": "US",
            "telephone_number": "303-797-9420",
            "fax_number": "303-797-9358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "29718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01297183",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Ann Black, MD
• Paulina Black
• Randi Black
• River Gilmore Black, MD
• Stephen A Black, MPT, DSC
• Carol Jean Blackard, M.D.
• Zailyn Prada Blackburn, MATS
• Nicole Blackford, PHARMD
• Robert Blackham
• Keren Shechter Blackman, MD

• Psychiatry Physician in Aurora, CO
• Providers in Aurora, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.

Verify at the official NPI Registry.