RYAN BLACK (PA-C) – Physician Assistant, NPI 1932452091
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,531 PHYSICIAN ASSISTANT in ID
Provider Addresses for RYAN BLACK (PA-C)
703 RIGBY LAKE DR
RIGBY, ID 834425192
Phone: (208) 745-0200
Fax: (208) 745-0212
Type: Location
2085 Providence Way
Idaho Falls, ID 834044945
Phone: (208) 516-1846
Fax: (208) 525-4885
Type: Location
6655 TRAVIS ST
SUITE 120
HOUSTON, TX 770301312
Phone:
Type: Mailing
451 N TEXAS AVE
WEBSTER, TX 775984927
Phone: (713) 528-8818
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $321.
Total Amount is formed as General ($321) + Research ($0) + Ownership ($0) = $321.
Last reported payment date: 2024-11-14 • Largest payer in this snapshot: LEO Pharma Inc. ($84).
Total Amount
$321
General + Research + Ownership
Payments
16
Total payment records
General Amount
$321
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-14
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2015-01-23
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 |
|---|---|---|---|---|
| I20150123000528 | I | Physician Assistant | ID | 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 | 1,561 | 338 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 593 | 474 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 522 | 418 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 186 | 169 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 154 | 148 | $0 |
Insurance plans in this area (ZIP 83442)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | ID | |
| D E R M A T O L O G Y | ID | |
| Physician Assistant | ID | |
| D E R M A T O L O G Y | MI | |
| D E R M A T O L O G Y | ID | |
| Physician Assistant | ID |
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