Jerrold Black, MD
NPI 1104833904 · Family Medicine Physician · Woodbridge, VA
Enrolled with Medicare as Practitioner - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jerrold Black, MD is a Family Medicine Physician provider in Woodbridge, VA (NPI 1104833904).
Provider details
- NPI number
- 1104833904
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 01063821A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-08-02
- Last updated
- 2011-02-28
Frequently asked questions
- What is Jerrold Black's NPI number?
- Jerrold Black's National Provider Identifier (NPI) is 1104833904, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jerrold Black's specialty?
- Jerrold Black is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Jerrold Black located?
- Jerrold Black's practice location on file with NPPES is 4167 Merchant Plz, Woodbridge, VA 22192-5088.
- What is Jerrold Black's phone number?
- The practice phone number listed in the NPPES registry for Jerrold Black is (703) 878-8800.
- Does Jerrold Black accept Medicare?
- Jerrold Black is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jerrold Black's NPI active?
- Yes — Jerrold Black's NPI (1104833904) is active in the NPPES registry as of the last update on 2011-02-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.