Ms Kisha Renee Black, APRN in Jacksonville, FL

Ms Kisha Renee Black, APRN is a medicare enrolled "Nurse Practitioner - Family" in Jacksonville, Florida. Her current practice location is 3625 University Blvd. S., Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 702-6089.

Ms Kisha Renee Black is licensed to practice in Florida (license number APRN11023957) 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 1760182893.

Contact Information

	Ms Kisha Renee Black, APRN
	3625 University Blvd. S., Jacksonville, FL 32216
	(904) 702-6089
	Not Available

Map and Direction

Provider's Profile

Full Name	Ms Kisha Renee Black
Gender	Female
Speciality	Nurse Practitioner - Family
Location	3625 University Blvd. S., 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: 1760182893
Provider Enumeration Date: 03/07/2023
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 4486011426
Enrollment ID: I20230606002110

Medical Identifiers

Medical identifiers for Ms Kisha Renee Black such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1760182893	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	APRN11023957 (Florida)	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. Ms Kisha Renee Black allows following entities to bill medicare on her behalf.

Entity Name	Jacksonville Hospitalists Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871535492 PECOS PAC ID: 3274591631 Enrollment ID: O20041231000013

Entity Name	Symphony Specialty Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1831878735 PECOS PAC ID: 7719340850 Enrollment ID: O20230823000498

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. Ms Kisha Renee 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
Ms Kisha Renee Black, APRN 3612 Double Blanch Lane, Orange Park, FL 32073 Ph: (904) 536-3680	Ms Kisha Renee Black, APRN 3625 University Blvd. S., Jacksonville, FL 32216 Ph: (904) 702-6089

Reviews and Comments

Nurse Practitioner Nurses in Jacksonville, FL

Mrs. Rhode L. Jean-aleger, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 10075 Gate Pkwy N Apt 102, Jacksonville, FL 32246 Phone: 904-997-9844 Fax: 904-997-9844
Jennifer Salenga Arguilla, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8773 Perimeter Park Ct, Jacksonville, FL 32216 Phone: 904-493-3390 Fax: 904-493-3395
Xenia T Blount, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Jessica Pelkowski, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Shannon Kathleen Burns, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Christy Mcewen, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 836 Prudential Dr Ste 1700b, Unit 1, Jacksonville, FL 32207 Phone: 904-398-0125 Fax: 904-389-1832
Danielle Harper Key, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4425 Merrimac Ave, Jacksonville, FL 32210 Phone: 904-346-0050 Fax: 904-346-0080

Ms Kisha Renee Black, APRN - Medicare Nurse Practitioner in Jacksonville, FL