MICHAELA BLACK (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1962268607
Psychiatric/Mental Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MICHAELA BLACK (PMHNP)
3300 N TRIUMPH BLVD STE 500
LEHI, UT 840436475
Phone: (801) 675-8990
Fax: (844) 270-1824
Type: Mailing
255 S ROUTT ST STE 250
LAKEWOOD, CO 802282214
Phone: (720) 316-9778
Type: Location
500 Discovery Pkwy Ste 250
Superior, CO 800278762
Phone: (720) 239-2352
Type: Location
4856 Innovation Dr
Fort Collins, CO 805255539
Phone: (970) 494-4200
Fax: (844) 270-1824
Type: Location
425 S Cherry St Fl 10
Denver, CO 802461226
Phone: (720) 307-6670
Type: Location
6071 E Woodmen Rd Ste 200
Colorado Springs, CO 809232609
Phone: (719) 204-6495
Type: Location
304 Inverness Way S Ste 225
Englewood, CO 801125841
Phone: (970) 310-3406
Type: Location
4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE, AZ 852517630
Phone:
Fax: (888) 965-4615
Type: Mailing
304 INVERNESS WAY S STE 225
ENGLEWOOD, CO 801125841
Phone: (970) 310-3406
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: 2025-04-02
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 |
|---|---|---|---|---|
| I20250402000681 | I | Nurse Practitioner | CO | 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 84043)
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