MOLLY BLACK
NPI 1114529674
Nurse Anesthetist, Certified Registered in Fort Polk, LA

Active since November 10, 2020Accepts Medicare Assignment
1585 3RD ST, FORT POLK, LA 71459(210) 862-9692 Get Directions Write a Review

NPPES record last updated: July 8, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 8, 2025, Jul 7, 2022, Jan 4, 2021 and 1 more (4 updates tracked since 2020).

About Molly Black NPPES

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

MOLLY BLACK (NPI 1114529674) is an individual nurse anesthetist, certified registered in Fort Polk, Louisiana, licensed in Texas (971137) and active in the NPI registry since November 2020. She is affiliated with Ohsu Hospital And Clinics, maintains 2 additional practice locations, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1114529674
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameMOLLY BLACK
Location Address1585 3RD STFort Polk, LA 71459-5102
Mailing Address43 Bassett StFort Bragg, NC 28307-2032
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateNovember 10, 2020
Last NPPES UpdateJuly 8, 20254 updates tracked since enumeration
NPPES CertifiedJuly 8, 2025
NPI 1114529674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
Licenses Licensed in TX · 971137 Licensed in OR · 10041796
Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

1585 3RD ST, Fort Polk, LA 71459

Secondary Practice Locations 2

Location 143 Bassett StFort Bragg, NC 28307-2032 · Phone (210) 862-9692
Location 23181 SW Sam Jackson Park RdPortland, OR 97239-3011 · Phone (503) 494-7641 · Fax (503) 494-4661

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Molly Black 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 ID4880104660
PECOS Enrollment IDI20250610003681

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ohsu Hospital And Clinics

Acute Care Hospitals · Portland, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number380009
Location3181 SW Sam Jackson Park RoadPortland, OR 97239 · Multnomah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 71459 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
$124.60 typical visit price
range $53.43 – $164.73
Typical copayment $31.15 (range $13.35 – $41.18)
Most-billed visit code 99204
Established Patient
$67.06 typical visit price
range $16.64 – $133.62
Typical copayment $16.76 (range $4.16 – $33.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Nurse Practitioner (Family)
1585 3RD ST
FORT POLK, LA 71459
Orthopaedic Surgery
1585 3RD ST, BOX 81
FORT POLK, LA 71459
Nurse Practitioner (Family)
1585 3RD ST, INTERNAL MEDICINE CLINIC
FORT POLK, LA 71459
Family Medicine
1585 3RD ST, BAYNE-JONES ARMY COMMUNITY HOSPITAL
FORT POLK, LA 71459
Physician Assistant
1585 3RD ST
FORT POLK, LA 71459
Physician Assistant
1585 3RD ST, MEDDAC-FP
FORT POLK, LA 71459
Physician Assistant
1585 3RD ST, BAYNE JONES ARMY COMMUNITY HOSPITAL
FORT POLK, LA 71459
Registered Nurse (Community Health)
1585 3RD ST
FORT POLK, LA 71459

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 Molly Black's NPI number?

The NPI number for Molly Black is 1114529674. It was assigned to this individual provider in the NPPES registry on November 10, 2020.

Where is Molly Black located?

Molly Black practices at 1585 3rd St, Fort Polk, LA 71459. The listed phone number is (210) 862-9692.

What is Molly Black's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Molly Black enrolled in Medicare?

Yes. Molly 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.

Is Molly Black affiliated with any hospitals?

According to CMS data, Molly Black is affiliated with Ohsu Hospital And Clinics.

When was this NPI record last updated?

The NPPES record for Molly Black was last updated on July 8, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.