NPIMap

Individual provider Active NPI

Joy Merry Black, PA

  • Physician Assistant
  • Schenectady, NY
National Provider Identifier
1881786515
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004974 Issued in NY
Practice address
1270 Belmont Ave
Schenectady, NY 12308-2104
Phone
(518) 382-4560
Fax
(518) 386-3619
NPI assigned
Sep 29, 2006
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 004974 NY Primary
Medical Physician Assistant 363AM0700X 004974 NY

Addresses

Primary practice location

1270 Belmont Ave
Schenectady, NY 12308-2104

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

1772 Helderberg Trl
Berne, NY 12023-2709
Phone (518) 872-9262

Other identifiers 1

IdentifierTypeStateIssuer
120522000020OtherNYFIDELIS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050302000355 NY Practitioner - Physician Assistant 8628021698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunnyview Hospital and Rehabilitation CenterGroup PAC ID 5496743072, 31 clinicians

Practice addresses (Care Compare)

1270 Belmont Ave
Schenectady, NY 12308-2104
Phone (518) 382-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
90.67
Improvement activities
10
Cost
78.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004974NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sand Creek Medical PC Past Accepting new patients
Capital Region Physical Therapy, PLLC PastSince Oct 23, 2006 Accepting new patients
Capital Region Neurosurgery, PLLC Past Accepting new patients
Community Care Physicians, PLLC Past Accepting new patients
Community Care Physicians, PC Physician Assistant PastSince Jan 1, 1998 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jblack834488@direct.trinity-health.org
  • Direct secure messaging: joy.black.p1@direct.tcfr.nextgenshare.com

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1881786515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 BELMONT AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082104",
            "telephone_number": "518-382-4560",
            "fax_number": "518-386-3619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1772 Helderberg Trl",
            "address_purpose": "LOCATION",
            "city": "Berne",
            "state": "NY",
            "postal_code": "120232709",
            "country_code": "US",
            "telephone_number": "518-872-9262",
            "fax_number": "518-872-9265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JOY",
        "middle_name": "MERRY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "004974",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "004974",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "120522000020",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP- Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1270 Belmont Ave",
            "city": "Schenectady",
            "state": "NY",
            "country_code": "US",
            "postal_code": "123082104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.