DR. JEANETTE MARIE BLACK (M.D.) – Procedural Dermatology Physician, NPI 1497070510
Procedural Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. JEANETTE MARIE BLACK (M.D.)
Corporate Circle, Green Valley Ranch, Henderson, Clark County, Nevada, 89074, United States
STE 200
HENDERSON, NV 890747759
Phone: (702) 360-2763
Fax: (949) 783-2880
Type: Mailing
Roku, 9201, West Sunset Boulevard, Sunset Strip, West Hollywood, Los Angeles County, California, 90069, United States
SUITE 602
LOS ANGELES, CA 900693701
Phone: (310) 246-0495
Fax: (310) 246-0496
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 53 Open Payments records for all available years, with a total value of $53,717.
Total Amount is formed as General ($53,717) + Research ($0) + Ownership ($0) = $53,717.
Last reported payment date: 2024-12-31 • Largest payer in this snapshot: ABBVIE INC. ($53,227).
Total Amount
$53,717
General + Research + Ownership
Payments
53
Total payment records
General Amount
$53,717
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $53,227 |
| Galderma Laboratories, L.P. | $200 |
| MERZ NORTH AMERICA, INC. | $172 |
| Novartis Pharmaceuticals Corporation | $42 |
| Gilead Sciences, Inc. | $34 |
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: 2016-12-05
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 |
|---|---|---|---|---|
| I20161205001741 | I | Dermatology | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 89074)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| Nurse Practitioner | NV | |
| - | CA | |
| - | CA | |
| - | NV | |
| D E R M A T O L O G Y | NV | |
| Dermatology, Micrographic Dermatologic Surgery (Mds), Pathology | TX | |
| D E R M A T O L O G Y | NV | |
| Physician Assistant | NV |
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