LOTTE BLACK – Physical Therapist, NPI 1023979044

LOTTE BLACK is a healthcare provider. based in Littleton, Colorado. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 0020934 (CO). The NPI Number for LOTTE BLACK is 1023979044

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
LOTTE BLACK
NPI
1023979044
Phone
(303) 933-9057
Address
10125 W SAN JUAN WAY
Enumeration Date
19 November 2025
Last Update Date
19 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7204931181
Graduation Year
2025 (1 year ago)
PAC ID
4688167034
Group Practice PAC ID
0648238410
Professional Enrollment ID
I20251212001925
Address ID
CO801276330LI10125WAYX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

2,986 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CO

Provider Addresses for LOTTE BLACK

  • 10125 W SAN JUAN WAY

    LITTLETON, CO 801276330

    Phone: (303) 933-9057

    Mailing address matches the actual address.

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: 2025-12-12

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251212001925IPhysical Therapist In Private PracticeCOTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80127)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648238410View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
-CO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO

Reviews

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Frequently asked questions

How do payers reference LOTTE BLACK?
For LOTTE BLACK, use NPI 1023979044 as the unique 10-digit identifier.
Is there an active status for LOTTE BLACK?
For scheduling context, LOTTE BLACK is shown as active in the registry.
What clinical focus is listed for LOTTE BLACK?
At a glance, LOTTE BLACK is tied to Physical Therapist. Clinical services aligned with this taxonomy classification.
Is LOTTE BLACK associated with Littleton?
Public fields place LOTTE BLACK around Littleton, Colorado. Always confirm the exact site before visiting.
Does LOTTE BLACK accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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