DR. EDWIN BLACK GEORGE (MD PHD) – Neurology Physician, NPI 1255378774

DR. EDWIN BLACK GEORGE (MD PHD) is a healthcare provider. based in Troy, Michigan. specializing in Neurology Physician. They hold the professional credentials MD PHD. They hold a License No. 4301068940 (MI). The NPI Number for DR. EDWIN BLACK GEORGE (MD PHD) is 1255378774

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
DR. EDWIN BLACK GEORGE (MD PHD)
NPI
1255378774
Phone
(313) 745-4275
Address
1560 E MAPLE RD
Enumeration Date
1 June 2006
Last Update Date
3 August 2016

Doctor Profile

Medical School Name
CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Secondary Phone
3137454275
Graduation Year
1987 (39 years ago)
PAC ID
7416969753
Group Practice PAC ID
8628087681
Professional Enrollment ID
I20060703000073
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for DR. EDWIN BLACK GEORGE (MD PHD)

  • 1560, East Maple Road, Troy, Oakland County, Michigan, 48083, United States

    SUITE 400-CREDENTIALING

    TROY, MI 480831138

    Phone: (313) 745-4275

    Fax: (313) 745-4468

    Type: Mailing

  • 4201 ST ANTOINE STE 8A & 8B

    UNIVERSITY HEALTH CENTER

    DETROIT, MI 482012153

    Phone: (313) 745-4275

    Fax: (313) 745-4468

    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: 2006-07-03

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
I20060703000073INeurologyMITBD

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 48083)

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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: 8628087681View full group profile
NameSpecialtyState
-MI
Nurse PractitionerMI
Cardiovascular Disease (Cardiology)MI
H O S P I T A L I S TMI
-MI
Pulmonary Disease, Internal Medicine, Critical Care (Intensivists)MI
Internal Medicine, Infectious DiseaseMI
O B S T E T R I C S/ G Y N E C O L O G YMI
Pulmonary Disease, Critical Care (Intensivists)MI
O P H T H A L M O L O G YPA

Reviews

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Frequently asked questions

What unique ID ties claims to DR. EDWIN BLACK GEORGE (MD PHD)?
NPI 1255378774 is assigned to DR. EDWIN BLACK GEORGE (MD PHD) under the national enumeration system.
Is DR. EDWIN BLACK GEORGE (MD PHD)'s NPI currently valid?
The extract we use shows DR. EDWIN BLACK GEORGE (MD PHD) as active.
Can you summarize DR. EDWIN BLACK GEORGE (MD PHD)'s specialty in plain language?
Clinically, the directory lists DR. EDWIN BLACK GEORGE (MD PHD) with Neurology Physician. Clinical services aligned with this taxonomy classification.
Where does public data place DR. EDWIN BLACK GEORGE (MD PHD)?
The snapshot lists Troy, Michigan for DR. EDWIN BLACK GEORGE (MD PHD); download NPPES for the complete set.
Is DR. EDWIN BLACK GEORGE (MD PHD) a real provider?
This page reflects official NPPES data for NPI 1255378774. Always confirm identity and privileges with the practice and licensing boards.

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