CIERRA CHARRSE BLACK (PA-C) – Physician Assistant, NPI 1104625383

CIERRA CHARRSE BLACK (PA-C) is a healthcare provider. based in Mckinney, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for CIERRA CHARRSE BLACK (PA-C) is 1104625383

Main info

Female
1 Year Of Experience
Name
CIERRA CHARRSE BLACK (PA-C)
NPI
1104625383
Phone
(214) 250-4924
Address
2400 EATON DR
Enumeration Date
11 March 2025
Last Update Date
11 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9725964005
Graduation Year
2025 (1 year ago)
PAC ID
5890211098
Group Practice PAC ID
6507235835
Professional Enrollment ID
I20250430003303
Address ID
TX750344253FR8380XPKWY303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for CIERRA CHARRSE BLACK (PA-C)

  • 2400 EATON DR

    MCKINNEY, TX 750728825

    Phone: (214) 250-4924

    Type: Mailing

  • 1411 N BECKLEY AVE STE 363

    DALLAS, TX 752031558

    Phone: (214) 305-8667

    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: 2025-04-30

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
I20250430003303IPhysician AssistantTXTBD

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 75072)

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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: 6507235835View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YIL
Physician AssistantTX
Nurse PractitionerTX
Physician AssistantTX
O T O L A R Y N G O L O G YTX

Reviews

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Frequently asked questions

How do I look up CIERRA CHARRSE BLACK (PA-C) by NPI?
Use NPI 1104625383 when you need to reference CIERRA CHARRSE BLACK (PA-C) in forms, claims, or directories.
Is CIERRA CHARRSE BLACK (PA-C)'s NPI currently valid?
The extract we use shows CIERRA CHARRSE BLACK (PA-C) as active.
What kind of provider is CIERRA CHARRSE BLACK (PA-C)?
The page reflects Physician Assistant for CIERRA CHARRSE BLACK (PA-C). Clinical services aligned with this taxonomy classification.
Where is CIERRA CHARRSE BLACK (PA-C)'s primary listing?
We display Mckinney, Texas because that is what the record indicates for CIERRA CHARRSE BLACK (PA-C).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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