THERESA MARIE BLACK (APRN) – Gerontology Nurse Practitioner, NPI 1164119269
Gerontology Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for THERESA MARIE BLACK (APRN)
PO BOX 361095
MELBOURNE, FL 329361095
Phone: (321) 253-2900
Fax: (321) 435-0100
Type: Mailing
402 N BABCOCK ST STE 102
MELBOURNE, FL 329357335
Phone: (321) 241-6540
Fax: (321) 428-4442
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 86 Open Payments records for all available years, with a total value of $2,010.
Total Amount is formed as General ($2,010) + Research ($0) + Ownership ($0) = $2,010.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($530).
Total Amount
$2,010
General + Research + Ownership
Payments
86
Total payment records
General Amount
$2,010
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $530 |
| Takeda Pharmaceuticals U.S.A., Inc. | $430 |
| Inogen, Inc. | $370 |
| Grifols USA, LLC | $326 |
| AstraZeneca Pharmaceuticals LP | $199 |
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: 2023-04-29
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 |
|---|---|---|---|---|
| I20230429000121 | I | Nurse Practitioner | FL | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 211 | 183 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 177 | 161 | $0 |
Insurance plans in this area (ZIP 32936)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Hospitalist | FL | |
| Internal Medicine, Geriatric Medicine | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Internal Medicine | FL | |
| Nurse Practitioner | FL | |
| Interventional Radiology | FL | |
| Physician Assistant | FL | |
| N E U R O L O G Y | FL |
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