Stuart Austin Black Iii, MD | |
223 16th Ave N, Nampa, ID 83687-4058 | |
(208) 466-7869 | |
(208) 466-5359 |
Full Name | Stuart Austin Black Iii |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 20 Years |
Location | 223 16th Ave N, Nampa, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053351361 | NPI | - | NPPES |
11000131 | Other | ID | MEDICARE PTAN |
11000133 | Other | ID | MEDICARE PTAN |
1053351361 | Medicaid | ID | |
11000132 | Other | ID | MEDICARE PTAN |
P00777176 | Other | ID | MEDICARE RAILROAD PTAN |
M9850 | Other | ID | IDAHO LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 01060962A (Indiana) | Secondary |
207Q00000X | Family Medicine | M-9850 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Saint Alphonsus Medical Center - Nampa | Nampa, ID | Hospital |
St Luke's Nampa Medical Center | Nampa, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Saint Alphonsus Regional Medical Center Inc | 3476462359 | 533 |
Community Health Clinics Inc | 4082527353 | 70 |
Sound Physicians Of Idaho | 4688705346 | 53 |
Entity Name | Community Health Clinics Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457309122 PECOS PAC ID: 4082527353 Enrollment ID: O20040130000055 |
Entity Name | Saint Alphonsus Regional Medical Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649357716 PECOS PAC ID: 3476462359 Enrollment ID: O20040204001036 |
Entity Name | Sound Physicians Of Idaho |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1730407461 PECOS PAC ID: 4688705346 Enrollment ID: O20100624000921 |
Mailing Address | Practice Location Address |
---|---|
Stuart Austin Black Iii, MD Po Box 9, Nampa, ID 83653-0009 Ph: (208) 466-7869 | Stuart Austin Black Iii, MD 223 16th Ave N, Nampa, ID 83687-4058 Ph: (208) 466-7869 |
Dr. Julia Marie Jensen, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 223 16th Ave N, Nampa, ID 83687 Phone: 208-466-7869 Fax: 208-466-5359 | |
Jason Johnston, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1820 Caldwell Blvd, Nampa, ID 83651 Phone: 208-466-6567 Fax: 208-466-7922 | |
Heidi Elizabeth Shields, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1150 N Sister Catherine Way, Nampa, ID 83687 Phone: 208-302-7000 Fax: 208-302-7055 | |
Robert B Buxton, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1510 12th Ave Rd, Ste 200, Nampa, ID 83886 Phone: 208-302-6800 Fax: 208-302-6855 | |
Dora Johnson, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 9850 W St Lukes Dr Ste 329, Nampa, ID 83687 Phone: 208-514-2509 Fax: 208-375-2217 | |
Jesse Tyler Mcchane, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 207 1st St S, Nampa, ID 83651 Phone: 208-466-7869 Fax: 208-466-5359 |