Individual provider Active NPI

Jonathan S. Black, M.D.

  • Plastic Surgery Physician
  • Charlottesville, VA
National Provider Identifier
1548463300
Registry record updated Sep 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
0101256477 Issued in VA
Practice address
1300 Jefferson Park Ave
Charlottesville, VA 22903-3363
Phone
(434) 924-5078
Fax
(434) 924-8118
NPI assigned
Jun 8, 2007
Last updated
Sep 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116019221 VA
Pediatrics Physician 208000000X 0101256477 VA
Plastic Surgery Physician 208200000X 0101256477 VA Primary

Addresses

Primary practice location

1300 Jefferson Park Ave
Charlottesville, VA 22903-3363

Mailing address

PO Box 749112
Atlanta, GA 30374-9112

Other practice location 1

1204 W Main St
Charlottesville, VA 22903-2824
Phone (434) 982-6100

Other practice location 2

629 Cedar Creek Grade Ste B
Winchester, VA 22601-2786
Phone (540) 678-3950

Other practice location 3

70 Medical Center Cir Ste 203
Fishersville, VA 22939-2273
Phone (540) 932-5571

Other practice location 4

1215 Lee St
Charlottesville, VA 22908-3363
Phone (434) 924-0211

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jblack9644@direct.healthsystem.virginia.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20141020002590 VA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Pediatric Medicine 3173744976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Pediatric Medicine
Education
University of Nebraska College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 Jefferson Park Ave
FL 4
Charlottesville, VA 22903-3363
Phone (434) 924-5125

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.45 of 100Reported as group
Quality
79.76
Promoting interoperability
100
Improvement activities
40
Cost
75.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision49
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101256477VAMDPediatrics Physician
0116019221VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Aug 20, 2014 Accepting new patients
Rector & Visitors of the University of Virginia PastSince Oct 19, 2020 Accepting new patients

Locations

1204 W Main St
Charlottesville, VA 22903
Phone (434) 924-0123

1300 Jefferson Park Ave
Fl 4
Charlottesville, VA 22903
Phone (434) 924-5078

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

70 Medical Center Cir
Ste 203
Fishersville, VA 22939
Phone (540) 932-5571

Interoperability endpoints

  • Direct secure messaging: jblack9644@direct.healthsystem.virginia.edu

Organizations & group practices 2

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 1

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789776000000",
    "number": "1548463300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 JEFFERSON PARK AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229033363",
            "telephone_number": "434-924-5078",
            "fax_number": "434-924-8118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1204 W Main St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229032824",
            "country_code": "US",
            "telephone_number": "434-982-6100",
            "fax_number": "434-982-0747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "629 Cedar Creek Grade Ste B",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012786",
            "country_code": "US",
            "telephone_number": "540-678-3950",
            "fax_number": "540-678-3950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 Medical Center Cir Ste 203",
            "address_purpose": "LOCATION",
            "city": "Fishersville",
            "state": "VA",
            "postal_code": "229392273",
            "country_code": "US",
            "telephone_number": "540-932-5571",
            "fax_number": "540-932-5772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229083363",
            "country_code": "US",
            "telephone_number": "434-924-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JONATHAN",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2026-09-19",
        "certification_date": "2026-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116019221",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101256477",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": "0101256477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jblack9644@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1300 Jefferson Park Ave",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229033363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.