NPIMap

Organization Active NPI

Jason a. Black M.D., Inc.

  • Primary Care Clinic/Center
  • Murrieta, CA
National Provider Identifier
1902113186
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
JASON A. BLACK M.D., INC.
Practice address
40700 California Oaks Rd
Suite 207
Murrieta, CA 92562-5789
Phone
(951) 677-2252
Fax
(951) 677-3838
NPI assigned
Sep 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Authorized official

Name
Dr. Jason A Black, M.D.NPI 1073587887
Title
President
Phone
(951) 491-4201

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

40700 California Oaks Rd
Suite 207
Murrieta, CA 92562-5789

Mailing address

24680 Jefferson Ave Ste a
Murrieta, CA 92562-9023
Phone (951) 677-2252

Other names 1

  • Valley Internal Physicians Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110127000888 CA Part B Supplier - Clinic/Group Practice 4880873421 Receives reassigned benefits from 1 practitioner
Practice locations: Murrieta, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1902113186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24680 JEFFERSON AVE STE A",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629023",
            "telephone_number": "951-677-2252",
            "fax_number": "951-677-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40700 CALIFORNIA OAKS RD",
            "address_2": "SUITE 207",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625789",
            "telephone_number": "951-677-2252",
            "fax_number": "951-677-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON A. BLACK M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-491-4201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Internal Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Internal Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.