Shaun Black, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS015075 Issued in PA

Practice address

201 State St
Erie, PA 16550-0002

Phone

(814) 877-6139

NPI assigned

Jun 12, 2008

Last updated

Aug 12, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, NY2 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 2

Specialty

Emergency Medicine

Education

Philadelphia College of Osteopathic Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Physician Practice PCGroup PAC ID 6709007701, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Chautauqua at Wca Hospital, Jamestown, NY, CCN 330239
• Upmc Northwest Hospital, Seneca, PA, CCN 390091

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sblack515178@upmc.direct-ci.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.

• Great Lakes Physician Practice PC

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1730599176

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Regional Health Services Inc

  • Family Medicine Physician
  • Erie, PA
  • NPI 1174520654

  Emergency Medicine

  Medicare reassignment NPD
• Jamestown Area Medical Associates, L.L.P.

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1528010766
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Upmc Northwest

  • Psychiatric Hospital Unit
  • Seneca, PA
  • NPI 1013090745
  Care Compare affiliation
• Upmc Northwest

  • General Acute Care Hospital
  • Seneca, PA
  • NPI 1619069440
  Care Compare affiliation
• Upmc Northwest

  • Ambulatory Surgical Clinic/Center
  • Seneca, PA
  • NPI 1922174747

  Hospital

  Care Compare affiliation
• Upmc Chautauqua at Wca

  dba UPMC Chautauqua WCA

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Jamestown, NY
  • NPI 1568023687
  Care Compare affiliation
• Upmc Chautauqua at Wca

  dba UPMC Chautauqua WCA

  • General Acute Care Hospital
  • Jamestown, NY
  • NPI 1770573222
  Care Compare affiliation

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1689834707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165500002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165500002",
            "telephone_number": "814-877-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "SHAUN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2026-08-12",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS015075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sblack515178@upmc.direct-ci.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Bishop
• Marion Polly C. Bitticker
• Amanda Bivens
• Amy Elizabeth Bixler Tomlison, PSY.D.
• Jenner Black
• Tammy Lynn Black, FNP-C
• Kaitlyn Marie Blackburn, DO
• Hope Blackford
• Irene T Blackford, PHD
• Mary Blackford, LCSW

• Emergency Medicine Physician in Erie, PA
• Providers in Erie, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.