Mrs Jessie Black, NP is a medicare enrolled "Nurse Practitioner - Family" in Chickasaw, Alabama. Her current practice location is 
608 Masterson Ave, Chickasaw, Alabama. You can reach out to her office (for appointments etc.) via phone at 
(251) 689-6356.
Mrs Jessie Black is licensed to practice in Alabama (license number 1-095422) 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 1740903681.
				
				
				
				
				
		 
		
		 
Provider's Profile
		
			
			
			| Full Name | Mrs Jessie Black | 
|---|
| Gender | Female | 
|---|
| Speciality | Nurse Practitioner - Family | 
|---|
| Location | 608 Masterson Ave, Chickasaw, Alabama | 
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
|---|
			
			 
			
						  NPI Data:
			
			- NPI Number: 1740903681
- Provider Enumeration Date: 09/26/2022
- Last Update Date: 06/26/2025
  Medicare PECOS Information:
- PECOS PAC ID: 3678943735
- Enrollment ID: I20230105002524
 
		 
		 
Medical Identifiers
		Medical identifiers for Mrs Jessie Black such as npi, medicare ID, medicare PIN, medicaid, etc.
		
		| Identifier | Type | State | Issuer | 
|---|
		| 1740903681 | NPI | - | NPPES | 
		
		 
Medical Taxonomies and Licenses
		
		| Taxonomy | Type | License (State) | Status | 
|---|
		| 363L00000X | Nurse Practitioner | 906372 (Mississippi) | Secondary | 
| 363LF0000X | Nurse Practitioner - Family | 1-095422 (Alabama) | 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. Mrs Jessie Black allows following entities to bill medicare on her behalf.
| Entity Name | Nephrology Associates Of Mobile, P.a. | 
|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
|---|
| Entity Identifiers | NPI Number: 1861477507 PECOS PAC ID: 8729061668
 Enrollment ID: O20040610001396
 | 
|---|
		 
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. Mrs Jessie 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 | 
|---|
		| Mrs Jessie Black, NP 608 Masterson Ave,
 Chickasaw, AL 36611-1618
 Ph: (251) 689-6356
 | Mrs Jessie Black, NP 608 Masterson Ave,
 Chickasaw, AL 36611-1618
 Ph: (251) 689-6356
 | 
		
		 
Reviews and Comments