Dr Angela Prevatt Black, MD in Jacksonville, FL

Dr Angela Prevatt Black, MD is a medicare enrolled "Otolaryngology - Pediatric Otolaryngology" physician in Jacksonville, Florida. Her current practice location is 10475 Centurion Pkwy N Ste 302, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 398-5437.

Dr Angela Prevatt Black is licensed to practice in Florida (license number ME115569) 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 1275793358.

Contact Information

	Dr Angela Prevatt Black, MD
	10475 Centurion Pkwy N Ste 302, Jacksonville, FL 32256-5004
	(904) 398-5437
	(904) 398-3077

Map and Direction

Physician's Profile

Full Name	Dr Angela Prevatt Black
Gender	Female
Speciality	Otolaryngology - Pediatric Otolaryngology
Location	10475 Centurion Pkwy N Ste 302, Jacksonville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1275793358
Provider Enumeration Date: 06/12/2008
Last Update Date: 07/01/2024

Medicare PECOS Information:

PECOS PAC ID: 4183845746
Enrollment ID: I20141023000805

Medical Identifiers

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

Identifier	Type	State	Issuer
1275793358	NPI	-	NPPES
'009304000	Medicaid	FL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207YP0228X	Otolaryngology - Pediatric Otolaryngology	ME115569 (Florida)	Primary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary

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 Angela Prevatt Black allows following entities to bill medicare on her behalf.

Entity Name	The Nemours Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1386658615 PECOS PAC ID: 9537072483 Enrollment ID: O20040109000252

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 Angela Prevatt 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 Angela Prevatt Black, MD 10475 Centurion Pkwy N Ste 302, Jacksonville, FL 32256-5004 Ph: (043) 985-4379	Dr Angela Prevatt Black, MD 10475 Centurion Pkwy N Ste 302, Jacksonville, FL 32256-5004 Ph: (904) 398-5437

Reviews and Comments

Otolaryngology Doctors in Jacksonville, FL

Dr. Alexander A Farag, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 836 Prudential Dr Ste 1601, Jacksonville, FL 32207 Phone: 904-396-8060 Fax: 904-390-7385
Dr. Erin Rae Spadaro Hamersley, D.O. Otolaryngology Medicare: Medicare Enrolled Practice Location: 554 Keily Street, Jacksonville, FL 32212 Phone: 757-953-7550 Fax: 757-953-7560
Charvar Jones, Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 532 Riverside Ave, Jacksonville, FL 32202 Phone: 904-791-6632
Robert C Sprecher, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 807 Childrens Way, Nemours Childrens Clinic, Jacksonville, Jacksonville, FL 32207 Phone: 904-697-3694 Fax: 904-697-3927
Samip Patel, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Jeffrey Paul Radabaugh, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 836 Prudential Dr Ste 1601, Jacksonville, FL 32207 Phone: 904-396-8060 Fax: 904-390-7385
Cheyenne Roohani, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 807 Childrens Way, Jacksonville, FL 32207 Phone: 904-697-3600 Fax: 904-687-3927

Dr Angela Prevatt Black, MD - Medicare Otolaryngology in Jacksonville, FL