Dr Eric Black, DDS in Green Valley, AZ - Medicare Dentist Provider

Dr Eric Black, DDS is a medicare enrolled "Dentist - Dental Public Health" provider in Green Valley, Arizona. His current practice location is 1260 S Campbell Ave, Green Valley, Arizona. You can reach out to his office (for appointments etc.) via phone at (520) 407-5617.

Dr Eric Black is licensed to practice in Arizona (license number 6899) 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 1154364305.

Contact Information

	Dr Eric Black, DDS
	1260 S Campbell Ave, Green Valley, AZ 85614-0504
	(520) 407-5617
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Eric Black
Gender	Male
Speciality	Dentist - Dental Public Health
Location	1260 S Campbell Ave, Green Valley, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154364305
Provider Enumeration Date: 06/14/2006
Last Update Date: 07/02/2021

Medicare PECOS Information:

PECOS PAC ID: 2466471008
Enrollment ID: I20190506002704

Medical Identifiers

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

Identifier	Type	State	Issuer
1154364305	NPI	-	NPPES
974156	Medicaid	AZ

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	DD2687 (New Mexico)	Secondary
1223D0001X	Dentist - Dental Public Health	6899 (Arizona)	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 Eric Black allows following entities to bill medicare on his behalf.

Entity Name	North Country Healthcare Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073583472 PECOS PAC ID: 8820981053 Enrollment ID: O20040210001107

Entity Name	United Community Health Center-maria Auxiliadora Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1093766867 PECOS PAC ID: 4587634472 Enrollment ID: O20040930000548

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 Eric 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 Eric Black, DDS Po Box 600, 167 North Main Street, Tuba City, AZ 86045-0600 Ph: (928) 283-2501	Dr Eric Black, DDS 1260 S Campbell Ave, Green Valley, AZ 85614-0504 Ph: (520) 407-5617

Reviews and Comments

Dentist in Green Valley, AZ

Dr. Chhama Sarawagi, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 86 W Esperanza Blvd Ste 200, Green Valley, AZ 85614 Phone: 520-625-7790 Fax: 520-339-6768
Dr. Bryan D Goldsmith, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 518 E Whitehouse Canyon Rd, Suite. 190, Green Valley, AZ 85614 Phone: 520-399-4100 Fax: 520-399-4103
James Patrick Burke, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 261 W Duval Rd, Green Valley, AZ 85614 Phone: 520-625-6920
Julie Ho, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1260 S Campbell Ave Bldg 1, Green Valley, AZ 85614 Phone: 520-407-5400
Erika M Wyatt, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 86 W Esperanza Blvd, Green Valley, AZ 85614 Phone: 520-625-7790 Fax: 520-399-3341
Steven Yap, DDS Dentist Medicare: Medicare Enrolled Practice Location: 18726 S Nogales Hwy Ste 100, Green Valley, AZ 85614 Phone: 520-625-4850

Dr Eric Black, DDS - Medicare Dentist in Green Valley, AZ