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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MATTHEW WINFIELD BLACK PA-C
NPI 1194543306
Physician Assistant in Charlotte, NC

Active since September 27, 2024PECOS Enrolled
10905 PROVIDENCE RD W STE 270, CHARLOTTE, NC 28277(704) 316-3410(704) 316-3420 Get Directions Write a Review

NPPES record last updated: July 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Matthew Winfield Black Pa-c NPPES

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

MATTHEW WINFIELD BLACK PA-C (NPI 1194543306) is an individual physician assistant in Charlotte, North Carolina, licensed in North Carolina (0010-14851) and active in the NPI registry since September 2024. He is enrolled in Medicare PECOS and maintains a secondary practice location in Albemarle.

NPPES Registry Identity

NPI1194543306
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMATTHEW WINFIELD BLACKCredential: PA-C
Location Address10905 PROVIDENCE RD W STE 270Charlotte, NC 28277-1538
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Phone(704) 316-3410
Fax(704) 316-3420
Sole ProprietorYes
Enumeration DateSeptember 27, 2024
Last NPPES UpdateJuly 3, 2026
NPPES CertifiedJuly 3, 2026
✔ NPI 1194543306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NC · 0010-14851
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
10905 PROVIDENCE RD W STE 270, Charlotte, NC 28277
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Secondary Practice Location 1

Location 1301 Yadkin StAlbemarle, NC 28001-3441 · Phone (980) 323-4000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Matthew Winfield Black Pa-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28277 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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 4

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

MS. LILA T DIVINE PA
Physician Assistant
10905 PROVIDENCE RD W STE 270
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-3410
TAYLOR AMANDA TUTEN PA
Physician Assistant
10905 PROVIDENCE RD W STE 270
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-3410
ADAM WAEL OMAR
Physician Assistant
10905 PROVIDENCE RD W STE 270
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-3410
ERIC JAMES CORLETT
Physician Assistant
10905 PROVIDENCE RD W STE 270
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-3410

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 Matthew Black's NPI number?

The NPI number for Matthew Black is 1194543306. It was assigned to this individual provider in the NPPES registry on September 27, 2024.

Where is Matthew Black located?

Matthew Black practices at 10905 Providence Rd W Ste 270, Charlotte, NC 28277. The listed phone number is (704) 316-3410.

What is Matthew Black's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Matthew Black enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Matthew Black was last updated on July 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days 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.