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

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: November 01, 2026.

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

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
Open in Google Maps ↗

Secondary Practice Location 1

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Providence Health Plan, Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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 Billing Reassignments

4

Medicare enrollment records show Elizabeth Black reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Community Health Partners
504 mi
Multi-Specialty
7257 N FRESNO ST
Fresno, CA 93720
  • Reassigned Medicare billing, California enrollment
  • 604 clinicians in this Medicare group
NPI 1952912420 (559) 324-4952
University Of California San Francisco
520 mi
Surgery
400 PARNASSUS AVE, MCB 300
San Francisco, CA 94143
  • Reassigned Medicare billing, California enrollment
  • 5,645 clinicians in this Medicare group
NPI 1346329380 (415) 353-2161
Ucsf Medical Group Business Services
520 mi
Internal Medicine
400 PARNASSUS AVE
San Francisco, CA 94122
  • Reassigned Medicare billing, California enrollment
  • 5,544 clinicians in this Medicare group
NPI 1477624104 (415) 353-2808
Ucsf Pediatrics Associates
521 mi
Pediatrics
505 PARNASSUS AVE
San Francisco, CA 94143
  • Reassigned Medicare billing, California enrollment
  • 1,159 clinicians in this Medicare group
NPI 1376614016 (415) 353-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAILEY LIZABETH COLLETTE MS
Dietitian, Registered (Nutrition, Pediatric)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7081
ARIANA LAWRENCE MS, RD, LD
Dietitian, Registered
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7081
NATALIE PARRISH LCSW
Social Worker (Clinical)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7340
DR. PAUL CHRISTIAN NEVILLE O.D.
Optometrist
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-6910
LINDSEY RAE WENDEL CPNP-PC
Nurse Practitioner (Pediatrics)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7011
JASON JOHN OVEROCKER PA-C
Physician Assistant (Surgical)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7370
KODY MICHAEL DUCLOS RD, LD
Dietitian, Registered (Nutrition, Pediatric)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7081
KELSEY EILEEN MOE PCP-NP
Nurse Practitioner (Pediatrics)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 706-5437

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elizabeth Black's NPI number?

The NPI number for Elizabeth Black is 1043697113. It was assigned to this individual provider in the NPPES registry on April 28, 2015.

Where is Elizabeth Black located?

Elizabeth Black practices at 305 E Jefferson St, Boise, ID 83712. The listed phone number is (208) 381-7336.

What is Elizabeth Black's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.

Is Elizabeth Black enrolled in Medicare?

Yes. Elizabeth Black is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Elizabeth Black's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elizabeth Black reassigns Medicare benefits to 4 organizations: Community Health Partners (Fresno, CA), University Of California San Francisco (San Francisco, CA), Ucsf Medical Group Business Services (San Francisco, CA) and Ucsf Pediatrics Associates (San Francisco, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Elizabeth Black's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Elizabeth Black accept?

Health plans from PacificSource Health Plans, Providence Health Plan and Select Health list Elizabeth Black as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Elizabeth Black was last updated on June 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.