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

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: August 02, 2026.

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

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

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.

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.

What insurance does Kaelan Black accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Kaelan 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 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 11 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.