Active NPI
Lisa Breaux Black, M.D.
- Family Medicine Physician
- New Smyrna Beach, FL
National Provider Identifier
1851484307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME164904
- Practice address
- 161 N Causeway Ste a
New Smyrna Beach, FL 32169-5328 - Phone
- (386) 424-1584
- Fax
- (386) 410-4800
- NPI assigned
- Oct 2, 2006
- Last updated
- Apr 3, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 22558 | LA | |
| Family Medicine Physician | 207Q00000X | ME164904 | FL | Primary |
Addresses
Primary practice location
161 N Causeway Ste a
New Smyrna Beach, FL 32169-5328
Mailing address
161 N Causeway Ste a
New Smyrna Beach, FL 32169-5328
Phone (386) 424-1584
Other practice location 1
1700 Kaliste Saloom
Building 6 Suite 600
Lafayette, LA 70508
Phone (337) 252-3099
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1490466 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Louisiana State University School of Medicine in New Orleans, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
161 N Causeway
Suite a
New Smyrna Beach, FL 32169-5328
Phone (386) 424-1584
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME164904 | FL | MD | Family Medicine Physician |
| 22558 | LA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center One Medical of Lafayette | Family Medicine | Current | Accepting new patients |
Locations
3900 Clark Rd
Ste L2
Sarasota, FL 34233
Phone (941) 210-0248
1700 Kaliste Saloom Rd
Ste 600
Lafayette, LA 70508
Phone (337) 252-3099
Networks
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Sarasota, FL
- NPI 1629279138
-
- Family Medicine Physician
- Lafayette, LA
- NPI 1558258681
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Adventhealth Home Care East Florida
- Home Health Agency
- Ormond Beach, FL
- NPI 1134161318
-
dba AdventHealth Daytona Beach
- General Acute Care Hospital
- Daytona Beach, FL
- NPI 1063426823
-
dba AdventHealth Daytona Beach
- Clinical Medical Laboratory
- Daytona Beach, FL
- NPI 1104696178
Hospital
-
dba AdventHealth New Smyrna Beach
- General Acute Care Hospital
- New Smyrna Beach, FL
- NPI 1871977942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775174400000",
"number": "1851484307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 N CAUSEWAY STE A",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321695328",
"telephone_number": "386-424-1584",
"fax_number": "386-410-4800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 N CAUSEWAY STE A",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321695328",
"telephone_number": "386-424-1584",
"fax_number": "386-410-4800"
}
],
"practiceLocations": [
{
"address_1": "1700 Kaliste Saloom",
"address_2": "Building 6 Suite 600",
"address_purpose": "LOCATION",
"city": "Lafayette",
"state": "LA",
"postal_code": "70508",
"country_code": "US",
"telephone_number": "337-252-3099",
"fax_number": "337-252-3096",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLACK",
"first_name": "LISA",
"middle_name": "BREAUX",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "22558",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME164904",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1490466",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Smyrna Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.