Eva Marie Black, APRN-C is a medicare enrolled "Nurse Practitioner - Family" in York, Alabama. Her current practice location is
415 Derby Dr, York, Alabama. You can reach out to her office (for appointments etc.) via phone at
(205) 392-9656.
Eva Marie Black is licensed to practice in Alabama (license number 1-168015) 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 1134765886.
Provider's Profile
Full Name | Eva Marie Black |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 415 Derby Dr, York, Alabama |
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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: 1134765886
- Provider Enumeration Date: 11/18/2019
- Last Update Date: 09/13/2023
Medicare PECOS Information:
- PECOS PAC ID: 8325419013
- Enrollment ID: I20230117000169
Medical Identifiers
Medical identifiers for Eva Marie Black such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1134765886 | NPI | - | NPPES |
1-168015 | Other | AL | ALABAMA LICENSE |
27493 | Other | TN | TN LICENSE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 901756 (Mississippi) | Secondary |
363LF0000X | Nurse Practitioner - Family | 27493 (Tennessee) | Secondary |
363LF0000X | Nurse Practitioner - Family | 1-168015 (Alabama) | 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. Eva Marie Black allows following entities to bill medicare on her behalf.
Entity Name | Grundy County Health Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1770588683 PECOS PAC ID: 6800844200 Enrollment ID: O20240214004077 |
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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. Eva Marie 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 |
Eva Marie Black, APRN-C 91 Phoenix Ave, Carrollton, AL 35447-2351 Ph: (662) 549-4050 | Eva Marie Black, APRN-C 415 Derby Dr, York, AL 36925-2117 Ph: (205) 392-9656 |
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