Thomas Black, NP in Edgewood, NM - Medicare Nurse Practitioner

Thomas Black, NP is a medicare enrolled "Nurse Practitioner - Family" in Edgewood, New Mexico. His current practice location is 104 Quail Trail, Unit B, Edgewood, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 208-0208.

Thomas Black is licensed to practice in New Mexico (license number 02922) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619346376.

Contact Information

	Thomas Black, NP
	104 Quail Trail, Unit B, Edgewood, NM 87015
	(505) 208-0208
	(505) 717-2884

Map and Direction

Provider's Profile

Full Name	Thomas Black
Gender	Male
Speciality	Nurse Practitioner - Family
Location	104 Quail Trail, Edgewood, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619346376
Provider Enumeration Date: 09/23/2015
Last Update Date: 07/26/2021

Medicare PECOS Information:

PECOS PAC ID: 1557670114
Enrollment ID: I20220301000390

Medical Identifiers

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

Identifier	Type	State	Issuer
1619346376	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	02922 (New Mexico)	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. Thomas Black allows following entities to bill medicare on his behalf.

Entity Name	Dhhs Phs Naihs Crownpoint Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114960093 PECOS PAC ID: 0143128041 Enrollment ID: O20031230000393

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. Thomas 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
Thomas Black, NP 104 Quail Trail, Unit B, Edgewood, NM 87015 Ph: (505) 208-0204	Thomas Black, NP 104 Quail Trail, Unit B, Edgewood, NM 87015 Ph: (505) 208-0208

Reviews and Comments

Nurse Practitioner Nurses in Edgewood, NM

Nathan Duane Cogburn, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7 Municipal Way, Edgewood, NM 87015 Phone: 505-281-3406
Vivienne Prinz, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 104 Quail Trl, Unit B, Edgewood, NM 87015 Phone: 505-208-0204
Thu Thanh Nguyen, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 104 Quail Trail, Unit B, Edgewood, NM 87015 Phone: 505-208-0204 Fax: 505-717-2884
Mary Ann Crow, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 104 Quail Trl, Edgewood, NM 87015 Phone: 505-208-0204
Tracy J. Graff, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7 Municipal Way, Edgewood, NM 87015 Phone: --
Cierra Dorado, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 104 Quail Trl, Edgewood, NM 87015 Phone: 505-208-0204
Chelsey Ann Weinbrecht, AGACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 143 Square H Rd, Edgewood, NM 87015 Phone: 505-363-1884

Thomas Black, NP - Medicare Nurse Practitioner in Edgewood, NM