Active NPI
Jonas Black, DOO
- Student in an Organized Health Care Education/Training Program
- Springfield, MA
National Provider Identifier
1649022344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 759 Chestnut St
Springfield, MA 01199-2818 - Phone
- (413) 794-0000
- NPI assigned
- Apr 4, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
759 Chestnut St
Springfield, MA 01199-2818
Mailing address
7611 Breezy Point LN Apt 207
Raleigh, NC 27617-6794
Phone (919) 612-3740
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250904004493 | NC | Order and Referring Only - Emergency Medicine | 1355887753 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752710400000",
"number": "1649022344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7611 BREEZY POINT LN APT 207",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276176794",
"telephone_number": "919-612-3740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "759 CHESTNUT ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011992818",
"telephone_number": "413-794-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "JONAS",
"credential": "DOO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-04",
"last_updated": "2025-07-17",
"certification_date": "2025-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.