Levi Ryan Black, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-OPT-LIC-4214 Issued in MT

Practice address

417 Main St SW
Ronan, MT 59864-2738

Phone

(406) 676-3937

NPI assigned

Jun 24, 2021

Sex

Male

Sole proprietor

No

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.

• Mission Valley Eye Center, Inc.

  • Optometrist
  • Ronan, MT
  • NPI 1063764173

  MT, Optometrist

  Medicare reassignment Care Compare group NPD

Specialty

Optometry

Education

Pacific University - College of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mission Valley Eye Center Inc 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 24, 2021.

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1831768779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 MAIN ST SW",
            "city": "RONAN",
            "state": "MT",
            "postal_code": "598642738",
            "telephone_number": "406-676-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 MAIN ST SW",
            "city": "RONAN",
            "state": "MT",
            "postal_code": "598642738",
            "telephone_number": "406-676-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "LEVI",
        "middle_name": "RYAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "OPT-OPT-LIC-4214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063764173",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Balance & Bloom Health Services LLC
• Jessica D Barnette, BCBA
• Elizabeth M Baxter, SWLC
• Jonathan Beard, DDS
• Joanna Billings, D.O.
• Eric V Boughton, D.C.
• Brainbox Psychiatry, LLC
• Timothy Donald Browne, M.D.
• Christina Bucarey, LAC, SWLC
• Stacey Marie Burdett, FNP-BC

• All providers in Ronan, MT
• Optometrist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.