Pamela O Black, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

97-192 Issued in NM

Practice address

3820 Commons Ave NE
Albuquerque, NM 87109-5831

Phone

(505) 343-1711

Fax

(505) 343-1862

NPI assigned

Apr 6, 2006

Last updated

Dec 13, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: pamelablack@qlmc.directglo.com

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.

• Pamela O Black MD, P.a., Dba Quadra Health Institute

  • Medical Physician Assistant
  • Albuquerque, NM
  • NPI 1336543115
  NPD (past) Authorized official
• Kenneth C. Lewis MD,LLC

  • Pain Medicine (Anesthesiology) Physician
  • Grand Junction, CO
  • NPI 1912639642
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1629030390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25206",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871250206",
            "telephone_number": "505-343-1711",
            "fax_number": "505-343-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 COMMONS AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871095831",
            "telephone_number": "505-343-1711",
            "fax_number": "505-343-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "PAMELA",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NM",
            "license": "97-192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Michael Black, RN
• Elizabeth (Beth) Black, PT
• Jennifer A Black
• Lauren Michelle Black, PA-S
• M. Sue Pullin Black, RPH
• Patricia Black, MD
• Randolph E Black, M.D.
• Stacy Renee Black, MS,PT
• Stephen R. Black, D.D.S.
• Vicki Heinz Black, LMFT

• Physical Medicine & Rehabilitation Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physical Medicine & Rehabilitation Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.