Jodie Black, CRNP is a medicare enrolled "Nurse Practitioner - Family" physician in Audubon, New Jersey. Her current practice location is
100 Black Horse Pike, Audubon, New Jersey. You can reach out to her office (for appointments etc.) via phone at
(844) 542-2273.
Jodie Black is licensed to practice in New Jersey (license number 26NJ00805900) 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 1194227207.
Physician's Profile
Full Name | Jodie Black |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 100 Black Horse Pike, Audubon, New Jersey |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1194227207
- Provider Enumeration Date: 03/05/2018
- Last Update Date: 03/04/2024
Medicare PECOS Information:
- PECOS PAC ID: 0840541413
- Enrollment ID: I20180920000903
Medical Identifiers
Medical identifiers for Jodie Black such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194227207 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | SP018556 (Pennsylvania) | Secondary |
363LF0000X | Nurse Practitioner - Family | 26NJ00805900 (New Jersey) | Primary |
207Q00000X | Family Medicine | 26NJ00805900 (New Jersey) | 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. Jodie Black allows following entities to bill medicare on her behalf.
Entity Name | Inspira Health Network Urgent Care Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1255613329 PECOS PAC ID: 2769657659 Enrollment ID: O20111205000169 |
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Entity Name | Inspira Sj Urgent Care Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1619320991 PECOS PAC ID: 0749566958 Enrollment ID: O20170424000682 |
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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. Jodie 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 |
Jodie Black, CRNP 100 Black Horse Pike, Audubon, NJ 08106-1950 Ph: (844) 542-2273 | Jodie Black, CRNP 100 Black Horse Pike, Audubon, NJ 08106-1950 Ph: (844) 542-2273 |
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