Charles Thomas Black, MD in Dallas, TX

Charles Thomas Black, MD is a medicare enrolled "Surgery - Pediatric Surgery" physician in Dallas, Texas. His current practice location is 12200 Park Central Dr Ste 400, Dallas, Texas. You can reach out to his office (for appointments etc.) via phone at (214) 483-9300.

Charles Thomas Black is licensed to practice in Texas (license number F3761) 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 1528049723.

Contact Information

	Charles Thomas Black, MD
	12200 Park Central Dr Ste 400, Dallas, TX 75251-2116
	(214) 483-9300
	(214) 483-9301

Map and Direction

Physician's Profile

Full Name	Charles Thomas Black
Gender	Male
Speciality	Surgery - Pediatric Surgery
Location	12200 Park Central Dr Ste 400, Dallas, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1528049723
Provider Enumeration Date: 11/07/2005
Last Update Date: 05/13/2020

Medicare PECOS Information:

PECOS PAC ID: 2264501725
Enrollment ID: I20100125000848

Medical Identifiers

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

Identifier	Type	State	Issuer
1528049723	NPI	-	NPPES
4130343	Other	TX	AETNA
138311911	Medicaid	TX
389962	Other	TX	ONE HEALTH PLAN
127631	Other	TX	SUPERIOR CHIP
80390N	Other		BLUE CROSS
153410004	Other	TX	PACIFICARE
3725428015	Other	TX	CIGNA
138311914	Other	TX	CSHCN
41814	Other	TX	AETNA MEDICAID
0134405	Other	TX	UNITED HEALTH CARE
10009560	Other	TX	AMERIGROUP
138311913	Medicaid	TX

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2086S0120X	Surgery - Pediatric Surgery	F3761 (Texas)	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. Charles Thomas Black allows following entities to bill medicare on his behalf.

Entity Name	Magella Medical Associates Billing Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083631071 PECOS PAC ID: 8729970215 Enrollment ID: O20041115001144

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. Charles 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
Charles Thomas Black, MD 12200 Park Central Dr Ste 400, Dallas, TX 75251-2116 Ph: (214) 483-9300	Charles Thomas Black, MD 12200 Park Central Dr Ste 400, Dallas, TX 75251-2116 Ph: (214) 483-9300

Reviews and Comments

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Charles Thomas Black, MD - Medicare Surgery in Dallas, TX