KAELAN DENDY YOUNG BLACK M.D.
NPI 1215226469
Otolaryngology - Pediatric Otolaryngology in Fairfax, VA

Q: What is Kaelan Black's NPI number?

The NPI number for Kaelan Black is 1215226469. It was assigned to this individual provider in the NPPES registry on March 28, 2011. The provider is also known as Kaelan Dendy Young.

Q: What is Kaelan Black's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Pediatric Otolaryngology, with taxonomy code 207YP0228X.

Q: When was this NPI record last updated?

The NPPES record for Kaelan Black was last updated on August 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since March 28, 2011PECOS EnrolledAccepts Medicare Assignment

3801 UNIVERSITY DR STE 300, FAIRFAX, VA 22030(703) 383-8130(703) 383-7350 Get Directions Write a Review

NPPES record last updated: August 29, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Kaelan Dendy Young Black M.d. NPPES

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

KAELAN DENDY YOUNG BLACK M.D. (NPI 1215226469) is an individual pediatric otolaryngology provider in Fairfax, Virginia, licensed in Virginia (0101263011) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS, maintains a secondary practice location in Portland, and is a graduate of Georgetown University School Of Medicine (2011).

NPPES Registry Identity

NPI1215226469

Entity TypeIndividualFemale

Primary Taxonomy207YP0228X

Provider Legal NameKAELAN DENDY YOUNG BLACKCredential: M.D.

Location Address3801 UNIVERSITY DR STE 300Fairfax, VA 22030-2503

Mailing Address3801 University Dr, Ste 200Fairfax, VA 22030-2503 · (703) 383-8130 · Fax (703) 383-7353

Phone(703) 383-8130

Fax(703) 383-7350

Sole ProprietorNo

Medical School CMSGeorgetown University School Of MedicineGraduated 2011

Enumeration DateMarch 28, 2011

Last NPPES UpdateAugust 29, 2025

NPPES CertifiedAugust 29, 2025

✔ NPI 1215226469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Pediatric OtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207YP0228X

Licenses✔ Licensed in VA · 0101263011✔ Licensed in OR · MD223309

Definition

A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing.

3801 UNIVERSITY DR STE 300, Fairfax, VA 22030

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Other Names 1

Former Name (1)Kaelan Dendy Young

Secondary Practice Location 1

Location 1501 N Graham St Ste 585Portland, OR 97227-1654 · Phone (503) 413-3690

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

Kaelan Dendy Young 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 ID8426314881

PECOS Enrollment IDI20171117002185, I20171204002410

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

Medicare enrollment records show Kaelan Black reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Otolaryngology Associates, PC

Same address

Otolaryngology

3801 UNIVERSITY DR, SUITE 200
Fairfax, VA 22030

Reassigned Medicare billing, District of Columbia and Virginia enrollments
33 clinicians in this Medicare group

NPI 1861534836 (703) 383-8130

Inova Health Care Services

4.1 mi

Multi-Specialty

2740 PROSPERITY AVE STE 200
Fairfax, VA 22031

Reassigned Medicare billing, Virginia enrollment
2,379 clinicians in this Medicare group

NPI 1669511051 (703) 321-2600

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

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

42 services39 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

38 services36 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

35 services33 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

18 services18 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

14 services13 patients

Other Providers at the Same Location NPPES 3

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

JENNIFER MCNAMARA POSTON PHD

Audiologist

3801 UNIVERSITY DR STE 300
FAIRFAX, VA 22030

Fairfax City (703) 383-8130

KATHERINE BAYLOR BARTHOLOMAY FNP-BC

Nurse Practitioner (Family)

3801 UNIVERSITY DR STE 300
FAIRFAX, VA 22030

Fairfax City (703) 383-8130

JACOB EDWIN KUPERSTOCK M.D.

Otolaryngology (Otolaryngology/Facial Plastic Surgery)

3801 UNIVERSITY DR STE 300
FAIRFAX, VA 22030

Fairfax City (703) 383-8130

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 Kaelan Black's NPI number?

The NPI number for Kaelan Black is 1215226469. It was assigned to this individual provider in the NPPES registry on March 28, 2011. The provider is also known as Kaelan Dendy Young.

Where is Kaelan Black located?

Kaelan Black practices at 3801 University Dr Ste 300, Fairfax, VA 22030. The listed phone number is (703) 383-8130.

What is Kaelan Black's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Pediatric Otolaryngology, with taxonomy code 207YP0228X.

Is Kaelan Black enrolled in Medicare?

Yes. Kaelan 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 organizations bill Medicare for Kaelan Black's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kaelan Black reassigns Medicare benefits to 2 organizations: Otolaryngology Associates, PC (Fairfax, VA) and Inova Health Care Services (Fairfax, VA). 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 Kaelan 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 Kaelan Black was last updated on August 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.