Theresa Marie Black, APRN in Melbourne, FL - Medicare Nurse Practitioner

Theresa Marie Black, APRN is a medicare enrolled "Nurse Practitioner - Gerontology" in Melbourne, Florida. Her current practice location is 402 N Babcock St Ste 102, Melbourne, Florida. You can reach out to her office (for appointments etc.) via phone at (321) 241-6540.

Theresa Marie Black is licensed to practice in Florida (license number APRN11025876) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1164119269.

Contact Information

	Theresa Marie Black, APRN
	402 N Babcock St Ste 102, Melbourne, FL 32935-7335
	(321) 241-6540
	(321) 428-4442

Map and Direction

Provider's Profile

Full Name	Theresa Marie Black
Gender	Female
Speciality	Nurse Practitioner - Gerontology
Location	402 N Babcock St Ste 102, Melbourne, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164119269
Provider Enumeration Date: 04/19/2023
Last Update Date: 04/19/2023

Medicare PECOS Information:

PECOS PAC ID: 4789049537
Enrollment ID: I20230429000121

Medical Identifiers

Medical identifiers for Theresa Marie Black such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164119269	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LG0600X	Nurse Practitioner - Gerontology	APRN11025876 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Theresa Marie Black allows following entities to bill medicare on her behalf.

Entity Name	Medical Associates Of Brevard Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1861400103 PECOS PAC ID: 4486558012 Enrollment ID: O20090123000389

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theresa Marie Black is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Theresa Marie Black, APRN Po Box 361095, Melbourne, FL 32936-1095 Ph: (321) 253-2900	Theresa Marie Black, APRN 402 N Babcock St Ste 102, Melbourne, FL 32935-7335 Ph: (321) 241-6540

Reviews and Comments

Nurse Practitioner Nurses in Melbourne, FL

Mrs. Dawn P Hamel, ARNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2290 W Eau Gallie Blvd, Melbourne, FL 32935 Phone: 321-435-1505 Fax: 321-426-7446
Mrs. Stephanie Louise Battaglini, ARNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1350 Hickory St Ste 102, Melbourne, FL 32901 Phone: 321-434-3452 Fax: 321-434-3456
Mr. Donald Lee Hulen, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1350 Hickory St, Melbourne, FL 32901 Phone: 321-434-7243
Mrs. Nicole Wiggins, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1314 Oak St, Melbourne, FL 32901 Phone: 321-727-7992 Fax: 321-727-7664
Tiffani Davidson, APRN, DNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1223 Gateway Dr Ste 2e, Melbourne, FL 32901 Phone: 321-361-5564
William Brandon Evans, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1350 Hickory St, Melbourne, FL 32901 Phone: 321-434-1771
Stacyann Stephens, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2626 Florencia Pl, Melbourne, FL 32940 Phone: 305-338-5141

Theresa Marie Black, APRN - Medicare Nurse Practitioner in Melbourne, FL