ELIZABETH ASHLEY BLACK MD
NPI 1043697113
Pediatrics - Pediatric Nephrology in Boise, ID

Q: What is the provider's specialty?

The provider's specialty is Pediatrics with taxonomy code 2080P0210X and a focus in Pediatric Nephrology.

Active since April 28, 2015PECOS Enrolled

75/100

CMS Quality Rating

305 E JEFFERSON ST, BOISE, ID 83712(208) 381-7336(208) 381-7495 Get Directions Write a Review

NPPES record last updated: June 3, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 3, 2026, Aug 5, 2021, Jun 28, 2021 (3 updates tracked since 2021).

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About Elizabeth Ashley Black Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZABETH ASHLEY BLACK MD (NPI 1043697113) is an individual pediatric nephrology provider in Boise, Idaho, licensed in Idaho (2971396) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Clovis.

NPPES Registry Identity

NPI1043697113

Entity TypeIndividualFemale

Primary Taxonomy2080P0210X

Provider Legal NameELIZABETH ASHLEY BLACKCredential: MD

Location Address305 E JEFFERSON STBoise, ID 83712-6231

Mailing Address190 E Bannock StBoise, ID 83712-6241 · (208) 381-8866

Phone(208) 381-7336

Fax(208) 381-7495

Sole ProprietorNo

Enumeration DateApril 28, 2015

Last NPPES UpdateJune 3, 20263 updates tracked since enumeration

NPPES CertifiedJune 3, 2026

✔ NPI 1043697113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPediatrics · Pediatric NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0210X

Licenses✔ Licensed in ID · 2971396✔ Licensed in CA · A151555

Definition

A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy.

Also ListedPediatricsTaxonomy 208000000X · License A151555 (CA)

Also ListedPediatrics · Obesity MedicineTaxonomy 2080B0002X · License A151555 (CA)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

305 E JEFFERSON ST, Boise, ID 83712

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Secondary Practice Location 1

Location 1726 N Medical Center Dr E Ste 209Clovis, CA 93611-6886 · Phone (559) 325-5656 · Fax (559) 325-5568

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth Ashley Black Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice