BLACK-PEARL MEDICAL LLC
NPI 1629963780
Point of Service in San Antonio, TX
About Black-pearl Medical Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLACK-PEARL MEDICAL LLC (NPI 1629963780) is a healthcare organization registered as a point of service in San Antonio, Texas and active in the NPI registry since June 2025. The organization lists Juliet Makena Gatobu, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Black-pearl Medical Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Black-Pearl Medical LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Black-Pearl Medical LLC's NPI number?
The NPI number for Black-Pearl Medical LLC is 1629963780. It was assigned to this organization in the NPPES registry on June 10, 2025.
Where is Black-Pearl Medical LLC located?
Black-Pearl Medical LLC is located at 12407 Walthampton St, San Antonio, TX 78216. The listed phone number is (316) 992-0034.
What is Black-Pearl Medical LLC's specialty?
The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.
Is Black-Pearl Medical LLC enrolled in Medicare?
Yes. Black-Pearl Medical LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Black-Pearl Medical LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Black-Pearl Medical LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Black-Pearl Medical LLC accept?
Health plans from Blue Cross and Blue Shield of Texas list Black-Pearl Medical LLC 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 Black-Pearl Medical LLC was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Black-Pearl Medical Llc · NPI 1629963780
Point of Service organization in San Antonio, Texas. Organization record, active in the CMS NPPES registry since June 10, 2025.
## Identity
- **NPI:** 1629963780 (Entity type: Organization)
- **Enumerated:** June 10, 2025
- **Primary specialty:** Point of Service · taxonomy 305S00000X
- **Organization subpart:** No
- **Authorized official:** Juliet Gatobu, OWNER
## Practice location
- **Address:** 12407 WALTHAMPTON ST, San Antonio, TX 78216-2944
- **Phone:** (316) 992-0034
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 29, 2026
- **Other identifiers:** Medicaid 1629963780 (TX)
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Source: [NPI Profile](https://npiprofile.com/npi/1629963780) · Data from the CMS NPPES public registry.