KELLY RENEE BLACK
NPI 1508384736
Physician Assistant in Clearwater, FL

Q: What is Kelly Black's NPI number?

The NPI number for Kelly Black is 1508384736. It was assigned to this individual provider in the NPPES registry on September 8, 2017.

Q: What is Kelly Black's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kelly Black was last updated on May 18, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 08, 2017PECOS EnrolledAccepts Medicare Assignment

430 MORTON PLANT ST STE 301, CLEARWATER, FL 33756(813) 978-9700 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 18, 2026, Dec 30, 2024, Oct 26, 2023 and 1 more (4 updates tracked since 2022).

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About Kelly Renee Black NPPES

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

KELLY RENEE BLACK (NPI 1508384736) is an individual physician assistant in Clearwater, Florida and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Tampa, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1508384736

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLY RENEE BLACK

Location Address430 MORTON PLANT ST STE 301Clearwater, FL 33756-3395

Mailing Address13020 N Telecom PkwyTemple Terrace, FL 33637-0915 · (813) 978-9700

Phone(813) 978-9700

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateSeptember 8, 2017

Last NPPES UpdateMay 18, 20264 updates tracked since enumeration

NPPES CertifiedMay 18, 2026

✔ NPI 1508384736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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.

Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X

430 MORTON PLANT ST STE 301, Clearwater, FL 33756

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Secondary Practice Location 1

Location 13301 W Gandy BlvdTampa, FL 33611-2931 · Phone (813) 925-1903 · Fax (813) 749-8370

Other Identifiers 1

Medicaid116670800FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Maintenance Organization of Florida, UnitedHealthcare, Wellpoint.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

Kelly Renee 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 ID8820474117

PECOS Enrollment IDI20221011001242

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 8

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 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.

39 services39 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

38 services38 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.

29 services29 patients

Detection test by immunoassay technique for influenza virus 87400

An immunoassay test for influenza virus is a procedure that identifies the presence of the flu virus in your body. It uses your body's immune response to detect specific proteins (antigens) associated with the virus. This helps in early and accurate diagnosis of influenza.

24 services12 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

23 services13 patients

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.

19 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33756 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

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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.

GEORGE WENDELL M. FELICIANO M.D.

Orthopaedic Surgery