Harold Micagah Black, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0024070513 Issued in VA

Practice address

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709

Phone

(703) 391-3129

Fax

(703) 295-9369

NPI assigned

Jul 19, 2005

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 4

Other names 1

• Mike Black Other name

Medicare fee-for-service enrollment

Enrolled in VA, DC, MD3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

George Washington University School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reston Anesthesia Associates PCGroup PAC ID 2567361124, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reston Hospital Center Hospital, Reston, VA, CCN 490107

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Reston Anesthesia Associates, PC

  • Anesthesiology Physician
  • Reston, VA
  • NPI 1932210093

  DC

  Medicare reassignment Care Compare group NPD
• Stonesprings Anesthesia Associates, LTD

  • Anesthesiology Physician
  • Dulles, VA
  • NPI 1255718235
  Medicare reassignment NPD
• North American Partners in Anesthesia Maryland LLC

  • Anesthesiology Physician
  • Prince Frederick, MD
  • NPI 1093707879
  Medicare reassignment
• Anesthesia Associates LTD.

  • Anesthesiology Physician
  • Alexandria, VA
  • NPI 1316947971
  NPD (past)

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

• Reston Hospital Center LLC

  dba Reston Hospital Center

  • General Acute Care Hospital
  • Reston, VA
  • NPI 1053363853
  Care Compare affiliation

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1831198084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37090",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973090",
            "telephone_number": "703-295-9360",
            "fax_number": "703-295-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 JOSEPH SIEWICK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331709",
            "telephone_number": "703-391-3129",
            "fax_number": "703-295-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "HAROLD",
        "middle_name": "MICAGAH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024070513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "139180",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831198084",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "298077",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "K142-0002",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKE",
            "last_name": "BLACK",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alexa Bitar
• BJ's Wholesale Club Inc.
• BJS Wholesale Club Inc (BJS Pharmacy)
• Alison Black, D.O.
• Gloria Gilbert Black, CRNA
• Janet Elizabeth Black, M.ED., BCBA
• Kaelan Dendy Young Black, M.D.
• Steven Michael Black, LPC
• Allison Blackman, LPC
• Dion Marcellus Blackmon, L.AC

• Certified Registered Nurse Anesthetist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Certified Registered Nurse Anesthetist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.