Samantha Monique Black, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

V6875 Issued in TX

Practice address

1615 Hospital Pkwy Ste 306
Bedford, TX 76022-5936

Phone

(817) 684-5100

Fax

(817) 684-5101

NPI assigned

Apr 8, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Texas Southwestern Medical School at Dallas, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epiphany Dermatology PAGroup PAC ID 3971827791, 106 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samantha.black@epiphanyderm.emadirect.md

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.

• Epiphany Dermatology PA

  • Dermatology Physician
  • Waco, TX
  • NPI 1043615263

  Dermatology, TX

  Medicare reassignment Care Compare group NPD
• John David Miller, M.D.P.a.

  • Specialist
  • Bedford, TX
  • NPI 1467581439
  NPD
• R Todd Plott MD PA

  • Dermatology Physician
  • Fort Worth, TX
  • NPI 1134426794

  Dermatology

  NPD

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1891375465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 RANCH ROAD 2222, BLDG 1, STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787303255",
            "telephone_number": "512-628-0465",
            "fax_number": "512-233-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 HOSPITAL PKWY STE 306",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760225936",
            "telephone_number": "817-684-5100",
            "fax_number": "817-684-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "SAMANTHA",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "V6875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Shaylynn Billups, MA, LPC
• Steven M Biorn, PT
• Birch Medical & Wellness
• Ashley N. Bixel, RD, LD
• Bailey Black, D.C.
• Bill Neff Blackmon Jr.
• Destiney Blackwell
• Lisa Blecher, M.S., CCC-SLP
• Neeraja Jagannadham Boddu, M.D.
• Patricia Spears Boersma, LCSW

• All providers in Bedford, TX
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.