Eric Black, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3462 Issued in CT

Practice address

1650 Dixwell Ave
Hamden, CT 06514-3615

Phone

(203) 288-1700

NPI assigned

Oct 20, 2015

Last updated

Oct 20, 2015By the provider in NPPES

Sex

Male

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 CT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physicians of Connecticut PCGroup PAC ID 8820390214, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Griffin Hospital Hospital, Derby, CT, CCN 070031
• St Vincent's Medical Center Hospital, Bridgeport, CT, CCN 070028

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

83.36

Promoting interoperability

100

Improvement activities

40

Cost

75.9

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Emergency Physicians of Connecticut PC

  • Emergency Medicine Physician
  • Waterbury, CT
  • NPI 1902278906
  Medicare reassignment Care Compare group
• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216
  Medicare reassignment NPD
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD

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

• SVMC Holdings, Inc

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1942224696
  Care Compare affiliation
• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  Care Compare affiliation

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1962874792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 8TH AVE",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351631",
            "telephone_number": "609-605-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143615",
            "telephone_number": "203-288-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ERIC",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-20",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "3462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renate Birmingham, DDS
• Ronald Brian Birmingham, DMD
• Erica E Bishop, MT
• Sarah Bishop, APRN
• Jacquelyn G Blaber, APRN, FNP-C
• Nakia S Black, LCSW
• Betty Blackwell
• Jeffrey Blain, LPN
• Adriana Blanco, M.D.
• Steven J Blander, M.D

• Medical Physician Assistant in Hamden, CT
• Providers in Hamden, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.