Ashley Black, PA-C
Individual provider Active NPI Physician Assistant · Grand Forks, ND
NPI 1710668595 · NPPES record last updated Jul 26, 2023
Key facts
- NPI
- 1710668595
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PAC1017 (ND)
- Practice address
- 4440 S. Washington St.
Grand Forks, ND 58201 - Phone
- (701) 732-7600
- NPI assigned
- Jul 26, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Altru Health System
Practice addresses (Care Compare)
1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-5000
1300 S Columbia Rd
Grand Forks, ND 58201-4012
Phone (701) 780-5000
1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000
4440 S Washington St
Grand Forks, ND 58201-7245
Phone (701) 780-5000
Hospital & facility affiliations
- Altru Hospital
- Unity Medical Center
- Northwood Deaconess Health Center
- Lifecare Medical Center
- Kittson Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230824000828 | ND | Practitioner - Physician Assistant | 9234592288 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAC1017 | ND | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Altru Health System | Current |
Accepting new patients | |
| Altru Health System | Current |
Accepting new patients |
Locations
1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000
4440 S Washington St
Fl 1
Grand Forks, ND 58201
2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891
4440 S Washington St
Grand Forks, ND 58201
Phone (701) 732-7000
901 2nd St
Langdon, ND 58249
Phone (701) 256-6100
301 5th St
Walhalla, ND 58282
Phone (701) 549-2711
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAC1017 | ND | Yes |
Addresses
Primary practice location
4440 S. Washington St.
Grand Forks, ND 58201
Mailing address
2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891
Other providers in Grand Forks, ND
- Jeffrey Scott Bjerke
- Sara Elizabeth Bjerke
- Barry A Bjorgaard
- Tara L Bjugstad
- Leah Bjur
- Bonnie Lou Black
- Fredric Lee Black
- Amanda Marie Blake
- Drew Michael Blake
- Blended Pathways Therapy, PLLC
All providers in Grand Forks, ND · Physician Assistant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.