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KYLIE RAEANN BLACK PA-C
NPI 1780302828
Physician Assistant in Monroe, WA

Active since August 15, 2022PECOS EnrolledAccepts Medicare Assignment
17707 W MAIN ST FL 1, MONROE, WA 98272(360) 282-3885(360) 512-2026 Get Directions Write a Review

NPPES record last updated: September 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 4, 2024, Apr 23, 2024, Aug 15, 2022 (3 updates tracked since 2022).

About Kylie Raeann Black Pa-c NPPES

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

KYLIE RAEANN BLACK PA-C (NPI 1780302828) is an individual physician assistant in Monroe, Washington, licensed in Washington (PA61482872) and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS, is affiliated with Evergreenhealth Monroe, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1780302828
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKYLIE RAEANN BLACKCredential: PA-C
Location Address17707 W MAIN ST FL 1Monroe, WA 98272-1967
Mailing AddressPo Box 34703Seattle, WA 98124-1703 · (536) 816-6262
Phone(360) 282-3885
Fax(360) 512-2026
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateAugust 15, 2022
Last NPPES UpdateSeptember 4, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 4, 2024
✔ NPI 1780302828 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 WA · PA61482872
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.
17707 W MAIN ST FL 1, Monroe, WA 98272
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Other Names 1

Former Name (1)Kylie Raeann Carter Pa-c

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Kylie Raeann Black Pa-c 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 ID9335584333
PECOS Enrollment IDI20240229002512
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Evergreenhealth Monroe

Acute Care Hospitals · Monroe, WA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number500084
Location14701 179th Ave SEMonroe, WA 98272 · Snohomish County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98272 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
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.

EVAN SIDNEY TEPLOW MD
Family Medicine
17707 W MAIN ST FL 1
MONROE, WA 98272
Snohomish County (360) 282-3885
SEA MAR COMMUNITY HEALTH CENTERS
Clinic/Center (Federally Qualified Health Center (FQHC))
17707 W MAIN ST FL 1
MONROE, WA 98272
Snohomish County (360) 282-3885
DR. KIRAN AGARWAL MD
Internal Medicine
17707 W MAIN ST FL 1
MONROE, WA 98272
Snohomish County (360) 282-3885
HANNAH RUSSELL
Dietitian, Registered
17707 W MAIN ST FL 1
MONROE, WA 98272
Snohomish County (360) 282-3885

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 Kylie Black's NPI number?

The NPI number for Kylie Black is 1780302828. It was assigned to this individual provider in the NPPES registry on August 15, 2022. The provider is also known as Kylie Raeann Carter Pa-C.

Where is Kylie Black located?

Kylie Black practices at 17707 W Main St Fl 1, Monroe, WA 98272. The listed phone number is (360) 282-3885.

What is Kylie Black's specialty?

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

Is Kylie Black enrolled in Medicare?

Yes. Kylie 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 Kylie Black accept?

Health plans from Providence Health Plan list Kylie 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.

Is Kylie Black affiliated with any hospitals?

According to CMS data, Kylie Black is affiliated with Evergreenhealth Monroe.

When was this NPI record last updated?

The NPPES record for Kylie Black was last updated on September 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.