Provider Type Icon

MARISSA BLACK M.D. NPI 1114269735


NPI Information

NPI: 1114269735
Provider Name: MARISSA BLACK, M.D.
Classification: Internal Medicine - 207RG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

PECOS Registration: Yes

Address:
11521 NE 128TH ST STE 100
KIRKLAND, WA
ZIP 98034
Phone: (425) 899-6800
Get Directions

Marissa Black, M.D. is a geriatric medicine internal medicine in Kirkland, WA with 11 years of experience. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. Marissa Black, M.D. NPI is 1114269735. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: TULANE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2013

The provider's business location address is:

11521 NE 128TH ST STE 100
KIRKLAND, WA
ZIP 98034
Phone: (425) 899-6800
Fax: (425) 899-6818

The NPI 1114269735 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem (HCPCS:G0180)
  • Removal of impact ear wax, one ear (HCPCS:69210)
  • Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report (HCPCS:93010)

The enumeration date for this NPI number is 3/21/2013 and was last updated on 7/17/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0300XInternal MedicineGeriatric MedicineMD60571983WASHINGTONYes
2207RG0300XInternal MedicineGeriatric MedicineMD60371542WASHINGTONNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.