MATTHEW WADE BLACK PA
NPI 1891415063
Physician Assistant - Medical in Grangeville, ID
About Matthew Wade Black Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MATTHEW WADE BLACK PA (NPI 1891415063) is an individual medical provider in Grangeville, Idaho, licensed in Idaho (PA-2620) and active in the NPI registry since August 2022. He is enrolled in Medicare PECOS, is affiliated with Syringa General Hospital, and maintains a secondary practice location in Kooskia.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted 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
Matthew Wade 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Syringa General Hospital
Critical Access Hospitals · Grangeville, IDOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GRANGEVILLE, ID 83530
GRANGEVILLE, ID 83530
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 Matthew Black's NPI number?
The NPI number for Matthew Black is 1891415063. It was assigned to this individual provider in the NPPES registry on August 29, 2022.
Where is Matthew Black located?
Matthew Black practices at 607 W Main St, Grangeville, ID 83530. The listed phone number is (208) 983-1700.
What is Matthew Black's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Matthew Black enrolled in Medicare?
Yes. Matthew 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 Matthew Black accept?
Health plans from Providence Health Plan list Matthew 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 Matthew Black affiliated with any hospitals?
According to CMS data, Matthew Black is affiliated with Syringa General Hospital.
When was this NPI record last updated?
The NPPES record for Matthew Black was last updated on October 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Matthew Wade Black, PA · NPI 1891415063
Medical physician in Grangeville, Idaho. Individual provider, active in the CMS NPPES registry since August 29, 2022.
## Identity
- **NPI:** 1891415063 (Entity type: Individual)
- **Enumerated:** August 29, 2022
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** PA-2620 (Idaho)
- **Sole proprietor:** No
## Practice location
- **Address:** 607 W MAIN ST, Grangeville, ID 83530-1345
- **Phone:** (208) 983-1700 · **Fax:** (208) 983-4665
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** October 25, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1891415063) · Data from the CMS NPPES public registry.