Katy A Black, APRN is a medicare enrolled "Nurse Practitioner" in Carbondale, Kansas. She graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Cotton O'neil Clinic Revocable Trust and her current practice location is
211 E Main St, Carbondale, Kansas. You can reach out to her office (for appointments etc.) via phone at
(785) 836-7111.
Katy A Black is licensed to practice in Kansas (license number 76631) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1043608920.
Provider's Profile
Full Name | Katy A Black |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Experience | 10 Years |
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Location | 211 E Main St, Carbondale, Kansas |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Katy A Black graduated from nursing school in 2014
NPI Data:
- NPI Number: 1043608920
- Provider Enumeration Date: 12/31/2014
- Last Update Date: 03/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 1456677863
- Enrollment ID: I20150302002362
Medical Identifiers
Medical identifiers for Katy A Black such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1043608920 | NPI | - | NPPES |
068002294 | Other | KS | MEDICARE |
201108160A | Medicaid | KS | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | 76631 (Kansas) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Cotton O'neil Clinic Revocable Trust | 5496659195 | 576 |
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. Katy A Black allows following entities to bill medicare on her behalf.
Entity Name | Cotton O'neil Clinic Revocable Trust |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1811944457 PECOS PAC ID: 5496659195 Enrollment ID: O20031124000674 |
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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. Katy A 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 |
Katy A Black, APRN 211 E Main St, Carbondale, KS 66414-9607 Ph: (785) 836-7111 | Katy A Black, APRN 211 E Main St, Carbondale, KS 66414-9607 Ph: (785) 836-7111 |
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