Individual provider Active NPI

Ryan Duane Black, D.O.

  • Otolaryngology Physician
  • Gillette, WY
National Provider Identifier
1619024544
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
14427A Issued in WY
Practice address
469 Highway 50
Gillette, WY 82718-9330
Phone
(307) 387-9850
Fax
(307) 387-9890
NPI assigned
Jan 4, 2007
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 14427A WY Primary
Otolaryngic Allergy Physician 207YX0602X 14427A WY

Addresses

Primary practice location

469 Highway 50
Gillette, WY 82718-9330

Mailing address

201 W Lakeway Rd Ste 1004
Gillette, WY 82718-6349
Phone (307) 387-9850

Other identifiers 1

IdentifierTypeStateIssuer
208D00000XOtherOKTAXONOMY CODE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, SD, WI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230222001084 WY Practitioner - Otolaryngology 2567472939 Reassigns benefits to 2 organizations
I20241212001543 SD Practitioner - Otolaryngology 2567472939 Reassigns benefits to 1 organization
I20260610003345 WI Practitioner - Otolaryngology 2567472939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2251 N Shore Dr
Rhinelander, WI 54501-6710

469 Hwy 50
Gillette, WY 82718-9330
Phone (307) 387-9850

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4276OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Hoskinson Health & Wellness Clinic LLC CurrentSince Mar 1, 2025 Accepting new patients
Powder River Surgery Center Current Accepting new patients
Campbell County Hospital District Current Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Nov 19, 2024 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Nov 19, 2024 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Hoskinson Health & Wellness Clinic LLC Current Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District CurrentSince Mar 1, 2023 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District CurrentSince Mar 1, 2023 Accepting new patients
Urgent Care of Green Country PLLC Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

4150 5th St
Rapid City, SD 57701
Phone (605) 399-4300

201 W Lakeway Rd
Ste 1004
Gillette, WY 82718
Phone (307) 387-9850

469 Wyoming Highway 50
Gillette, WY 82718
Phone (307) 387-9850

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

501 S Burma Ave
Fl 3
Gillette, WY 82716
Phone (307) 688-3636

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26742/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ryan.black.1@26742.direct.athenahealth.com

Organizations & group practices 14

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.

View all 14

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1619024544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W LAKEWAY RD STE 1004",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186349",
            "telephone_number": "307-387-9850",
            "fax_number": "307-387-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 HIGHWAY 50",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827189330",
            "telephone_number": "307-387-9850",
            "fax_number": "307-387-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "RYAN",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WY",
            "license": "14427A",
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "WY",
            "license": "14427A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY CODE",
            "identifier": "208D00000X",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

Verify at the official NPI Registry.