NICOLE BLACK (PA-C) – Physician Assistant, NPI 1043874910
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
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Provider Addresses for NICOLE BLACK (PA-C)
707 PARK AVE NE APT 1281
ATLANTA, GA 303263405
Phone: (810) 391-6679
Type: Mailing
Peachtree Dunwoody Road, Atlanta, Fulton County, Georgia, 30328, United States
ATLANTA, GA 303421699
Phone: (404) 257-1589
Type: Location
111 MARBLE MILL RD NW
MARIETTA, GA 300601047
Phone: (770) 422-1013
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 116 Open Payments records for all available years, with a total value of $3,257.
Total Amount is formed as General ($3,257) + Research ($0) + Ownership ($0) = $3,257.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: GENZYME CORPORATION ($1,044).
Total Amount
$3,257
General + Research + Ownership
Payments
116
Total payment records
General Amount
$3,257
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 |
|---|---|
| GENZYME CORPORATION | $1,044 |
| Dermavant Sciences, Inc. | $415 |
| Regeneron Healthcare Solutions, Inc. | $389 |
| Medimetriks Pharmaceuticals, Inc. | $250 |
| ABBVIE INC. | $240 |
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: 2021-01-06
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 |
|---|---|---|---|---|
| I20210106000708 | I | Physician Assistant | GA | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 391 | 59 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 164 | 144 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 86 | 81 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 64 | 62 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 52 | 51 | $0 |
Insurance plans in this area (ZIP 30326)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| D E R M A T O L O G Y | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| D E R M A T O L O G Y | GA | |
| D E R M A T O L O G Y | GA | |
| Physician Assistant | GA | |
| D E R M A T O L O G Y | GA |
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