Andrew P Black, PA - C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50-002937 Issued in OH

Practice address

6438 Wilmington Pike Ste 110
Dayton, OH 45459-7021

Phone

(937) 848-4121

Fax

(937) 848-5965

NPI assigned

Oct 27, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Susan MurphyGroup PAC ID 4587177365, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Homecare Home health agency, Kettering, OH, CCN 367778
• Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
• Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Susan Murphy

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1154211027
  Medicare reassignment Care Compare group

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

• Alternate Solutions Homecare of Dayton, LLC

  • Home Health Agency
  • Kettering, OH
  • NPI 1639195332
  Care Compare affiliation
• Beavercreek Medical Center

  • General Acute Care Hospital
  • Beavercreek, OH
  • NPI 1760764849
  Care Compare affiliation
• Dayton Osteopathic Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Fidelity Health Care Inc

  • Home Health Agency
  • Moraine, OH
  • NPI 1235127838
  Care Compare affiliation
• Kettering Medical Center

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Kettering Medical Center

  • General Acute Care Hospital
  • Miamisburg, OH
  • NPI 1316966518
  Care Compare affiliation
• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1790011724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6438 WILMINGTON PIKE STE 110",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454597021",
            "telephone_number": "937-848-4121",
            "fax_number": "937-848-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6438 WILMINGTON PIKE STE 110",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454597021",
            "telephone_number": "937-848-4121",
            "fax_number": "937-848-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ANDREW",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PA - C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-27",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50-002937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-OH",
            "identifier": "000000636013",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tasjanea K Bivens
• Gary Michael Bixler, MD
• Aliyah Renae Bizimana, LPC
• Oceana S. Bjerke, PHARMD, BCMTMS
• Theresa Blachly-Flanagan
• Aveeavis Terryseena Black, LCDCIII , SWCA
• Carrie Jeanne Black, ASSOC.
• Dion Black
• Janet Linn Black, LPCC-S
• Kristin Lee Black, RDH, OMT

• Medical Physician Assistant in Dayton, OH
• Providers in Dayton, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.