Dr Mary Lewis Black, MD in Fort Gordon, GA

Dr Mary Lewis Black, MD is a medicare enrolled "Pediatrics" physician in Fort Gordon, Georgia. Her current practice location is 300 W Hospital Rd, Fort Gordon, Georgia. You can reach out to her office (for appointments etc.) via phone at (706) 787-7300.

Dr Mary Lewis Black is licensed to practice in Georgia (license number 059094) 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 1780716084.

Contact Information

	Dr Mary Lewis Black, MD
	300 W Hospital Rd, Fort Gordon, GA 30905-5741
	(706) 787-7300
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Mary Lewis Black
Gender	Female
Speciality	Pediatrics
Location	300 W Hospital Rd, Fort Gordon, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780716084
Provider Enumeration Date: 03/12/2007
Last Update Date: 11/17/2025

Medicare PECOS Information:

PECOS PAC ID: 8527169473
Enrollment ID: I20070723000623

Medical Identifiers

Medical identifiers for Dr Mary Lewis Black such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780716084	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	059094 (Georgia)	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. Dr Mary Lewis Black allows following entities to bill medicare on her behalf.

Entity Name	Acs Primary Care Physicians - Southeast Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1861430555 PECOS PAC ID: 5193620714 Enrollment ID: O20040901000766

Entity Name	Wellstar Medical Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374

Entity Name	Central Georgia Emergency Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598126641 PECOS PAC ID: 5991004608 Enrollment ID: O20160502001926

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. Dr Mary Lewis 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
Dr Mary Lewis Black, MD 300 W Hospital Rd, Fort Gordon, GA 30905-5741 Ph: (706) 787-7300	Dr Mary Lewis Black, MD 300 W Hospital Rd, Fort Gordon, GA 30905-5741 Ph: (706) 787-7300

Reviews and Comments

Pediatrics Doctors in Fort Gordon, GA

Dr. Sharon Lynne Cody Greer, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 300 W Hospital Rd, Ddeamc, Fort Gordon, GA 30905 Phone: 706-787-9355
James H Mccrory, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 300 W Hospital Rd, Fort Gordon, GA 30905 Phone: 706-787-9123
Dr. Urmila Kosuri, M.D Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 300 W Hospital Rd, Eisenhower Hospital, Fort Gordon, GA 30905 Phone: 706-787-2720 Fax: 706-787-8176
Dr. Amrutha Nataraj, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 300 E. Hospital Road, Family Practice Clinic, Fort Gordon, GA 30905 Phone: 706-787-9252
Dr. Hosamane S Prabhakara, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 300 East Hospital Road, Eishenhower Medical Ctr, Fort Gordon, GA 30905 Phone: 706-787-9123
Dr. Mark Stephen Craig, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Dwight D. Eisenhower Army Medical Center, 300 E. Hospital Rd, Fort Gordon, GA 30905 Phone: 253-948-4858 Fax: 253-968-3278

Dr Mary Lewis Black, MD - Medicare Pediatrics in Fort Gordon, GA