Ancilla Black

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

881 Lorenz Ave
North Baldwin, NY 11510-2822

Phone

(516) 514-4793

NPI assigned

Oct 14, 2015

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1689045833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 LORENZ AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102822",
            "telephone_number": "516-514-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 LORENZ AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102822",
            "telephone_number": "516-514-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ANCILLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Bernstein, L.AC.
• Edgar Joseph Biazon, PT
• Wendy Bien-Aime, LPN
• Carrie Bilitzki
• Jason Todd Birnhak, DC
• Karene Ortensa Blake, RN
• Robert T. Bonacker, D.D.S.
• Godfrid Bosse
• Kenya Bradley, MSED
• Sheila Brennan

• Case Manager/Care Coordinator in North Baldwin, NY
• Providers in North Baldwin, NY by specialty
• Case Manager/Care Coordinator in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.