Serena Star Black, MD
Individual provider Active NPI Pediatrics Physician · Springfield, OR
NPI 1508007675 · NPPES record last updated Aug 17, 2026
Key facts
- NPI
- 1508007675
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD154349 (OR)
- Practice address
- 3377 Riverbend Dr
Springfield, OR 97477-8803 - Phone
- (541) 222-8500
- NPI assigned
- Mar 18, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110726000687 | OR | Practitioner - Pediatric Medicine | 2466620042 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD154349 | OR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Current |
Accepting new patients | |
| Peacehealth Medical Group | Pediatrics | Current |
Accepting new patients |
| Peacehealth Medical Group | Current |
Accepting new patients | |
| Peacehealth | Past | Accepting new patients |
Locations
4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300
390 9th St
Florence, OR 97439
Phone (541) 997-7134
400 9th St
Florence, OR 97439
Phone (541) 997-8412
1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253
Interoperability endpoints
- sblack2922@direct.peacehealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD154349 | OR | Yes |
Addresses
Primary practice location
3377 Riverbend Dr
Springfield, OR 97477-8803
Mailing address
PO Box 24410
Eugene, OR 97402-0451
Other practice location 1
1400 Valley River Dr Ste 110
Eugene, OR 97401-6758
Phone (541) 222-7370
Other practice location 2
390 9th St
Florence, OR 97439-9470
Phone (541) 997-7134
Other practice location 3
1515 Village Dr
Cottage Grove, OR 97424-9700
Phone (541) 942-6614
Other providers in Springfield, OR
- Paul L. Binder
- Michelle L Birdseye
- Peter Bissonnette
- Frank Bittner
- Belize Blachly
- Lori Blake
- Jane Bland
- Andrea Blattler
- Cindy Bloom
- Charles Michael Bloom, Jr.
All providers in Springfield, OR · Pediatrics Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.