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JORDAN DALE BLACK PA
NPI 1881421493
Physician Assistant in San Francisco, CA

Active since September 17, 2024PECOS EnrolledAccepts Medicare Assignment
505 PARNASSUS AVE # M917, SAN FRANCISCO, CA 94143(415) 353-1116 Get Directions Write a Review

NPPES record last updated: November 20, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Nov 20, 2024, Sep 17, 2024 (2 updates tracked since 2024).

About Jordan Dale Black Pa NPPES

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

JORDAN DALE BLACK PA (NPI 1881421493) is an individual physician assistant in San Francisco, California, licensed in California (64942) and active in the NPI registry since September 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1881421493
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJORDAN DALE BLACKCredential: PA
Location Address505 PARNASSUS AVE # M917San Francisco, CA 94143-2204
Mailing Address505 Parnassus Ave Ste M917San Francisco, CA 94143-2204 · (415) 353-1116 · Fax (415) 353-1990
Phone(415) 353-1116
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateSeptember 17, 2024
Last NPPES UpdateNovember 20, 20242 updates tracked since enumeration
NPPES CertifiedNovember 20, 2024
✔ NPI 1881421493 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 CA · 64942
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.
505 PARNASSUS AVE # M917, San Francisco, CA 94143
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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

Jordan Dale Black Pa 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 ID9931631371
PECOS Enrollment IDI20241010001251
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94143 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
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.

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 Jordan Black's NPI number?

The NPI number for Jordan Black is 1881421493. It was assigned to this individual provider in the NPPES registry on September 17, 2024.

Where is Jordan Black located?

Jordan Black practices at 505 Parnassus Ave # M917, San Francisco, CA 94143. The listed phone number is (415) 353-1116.

What is Jordan Black's specialty?

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

Is Jordan Black enrolled in Medicare?

Yes. Jordan 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.

When was this NPI record last updated?

The NPPES record for Jordan Black was last updated on November 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.