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MARISSA BLACK M.D.
NPI 1114269735
Internal Medicine - Geriatric Medicine in Kirkland, WA

Active since March 21, 2013PECOS EnrolledAccepts Medicare Assignment
11521 NE 128TH ST STE 100, KIRKLAND, WA 98034(425) 899-6800(425) 899-6818 Get Directions Write a Review

NPPES record last updated: July 17, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 17, 2019, Jul 14, 2016 (2 updates tracked since 2016).

About Marissa Black M.d. NPPES

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

MARISSA BLACK M.D. (NPI 1114269735) is an individual geriatric medicine provider in Kirkland, Washington, licensed in Washington (MD60571983) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Tulane University School Of Medicine (2013).

NPPES Registry Identity

NPI1114269735
Entity TypeIndividualFemale
Primary Taxonomy207RG0300X
Provider Legal NameMARISSA BLACKCredential: M.D.
Location Address11521 NE 128TH ST STE 100Kirkland, WA 98034
Mailing Address11521 Ne 128th St Ste 100Kirkland, WA 98034-4317 · (425) 899-6800 · Fax (425) 899-6818
Phone(425) 899-6800
Fax(425) 899-6818
Sole ProprietorNo
Medical School CMSTulane University School Of MedicineGraduated 2013
Enumeration DateMarch 21, 2013
Last NPPES UpdateJuly 17, 20192 updates tracked since enumeration
✔ NPI 1114269735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
Licenses✔ Licensed in WA · MD60571983✔ Licensed in WA · MD60371542
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
11521 NE 128TH ST STE 100, Kirkland, WA 98034
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1325 9th Ave, Box 359755, Rm. 5048 PSBSeattle, WA 98104-2420 · Phone (206) 744-9102 · Fax (206) 744-9976
Location 21660 S Columbian WaySeattle, WA 98108-1532 · Phone (206) 762-1010
Location 311521 NE 128th St Ste 100Kirkland, WA 98034 · Phone (425) 899-6800 · Fax (425) 899-6818

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marissa Black M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214251065
PECOS Enrollment IDI20170119002104
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 Reassignment

Medicare enrollment records show Marissa Black reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

King County Public Hospital District No 2
Same address
Internal Medicine
11521 NE 128TH ST, STE 100
Kirkland, WA 98034
  • Reassigned Medicare billing, Washington enrollment
  • 1,074 clinicians in this Medicare group
NPI 1548350713 (425) 899-6800

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98034 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$189.37 typical visit price
range $63.67 – $189.37
Typical copayment $47.34 (range $15.91 – $47.34)
Most-billed visit code 99205
Established Patient
$111.00 typical visit price
range $21.12 – $155.00
Typical copayment $27.75 (range $5.28 – $38.75)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers21 claims44 services$6.66 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

KATHLEEN LOUISE COCKRILL RPH
Pharmacist (Geriatric)
11521 NE 128TH ST STE 100, EVERGREEN SENIOR HEALTH SPECIALISTS
KIRKKLAND, WA 98034
King County (425) 899-6800
REZA TABIBI MD
Family Medicine (Geriatric Medicine)
11521 NE 128TH ST STE 100
KIRKLAND, WA 98034
King County (425) 899-6800
KRISTA LYNN HARRIS RPH
Pharmacist (Geriatric)
11521 NE 128TH ST STE 100
KIRKLAND, WA 98034
King County (425) 899-6800
ERIN JURY PHARMD
Pharmacist (Geriatric)
11521 NE 128TH ST STE 100
KIRKLAND, WA 98034
King County (425) 899-6807

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 Marissa Black's NPI number?

The NPI number for Marissa Black is 1114269735. It was assigned to this individual provider in the NPPES registry on March 21, 2013.

Where is Marissa Black located?

Marissa Black practices at 11521 NE 128th St Ste 100, Kirkland, WA 98034. The listed phone number is (425) 899-6800.

What is Marissa Black's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is Marissa Black enrolled in Medicare?

Yes. Marissa Black is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Marissa Black's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marissa Black reassigns Medicare benefits to King County Public Hospital District No 2 (Kirkland, WA). The 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 Marissa Black's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Marissa Black was last updated on July 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.