JORDAN BLACK (M.D.) – Anesthesiology Physician, NPI 1245658210
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,371 ANESTHESIOLOGY in CA
Provider Addresses for JORDAN BLACK (M.D.)
1205 PACIFIC HWY
UNIT 1304
SAN DIEGO, CA 921013327
Phone: (315) 317-6720
Type: Mailing
200 W ARBOR DR
#8770
SAN DIEGO, CA 921039000
Phone: (619) 543-5297
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-11-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241125001826 | I | Anesthesiology | MT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 23 | 23 | $0 |
| 00813 | Anesthesia for procedure on small and large bowel using an endoscope | 22 | 22 | $0 |
| 00142 | Anesthesia for lens surgery | 20 | 20 | $0 |
| 01402 | Anesthesia for procedure for total knee joint replacement | 14 | 14 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 13 | 13 | $0 |
Insurance plans in this area (ZIP 92101)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | MT | |
| A N E S T H E S I O L O G Y | WA | |
| A N E S T H E S I O L O G Y | UT | |
| A N E S T H E S I O L O G Y | WA | |
| A N E S T H E S I O L O G Y | MT | |
| A N E S T H E S I O L O G Y | WA | |
| A N E S T H E S I O L O G Y | MT | |
| A N E S T H E S I O L O G Y | WA | |
| A N E S T H E S I O L O G Y | MN | |
| A N E S T H E S I O L O G Y | ND |
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