Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ian Charles Black, PA-C

Individual provider Physician Assistant · NPI 1538678248

Ian Charles Black, PA-C is a Physician Assistant in Fort Myers, Florida. Qualified in 2017, 9 years ago. Practices with Wake Emergency Physicians PA, a 273-clinician group and accepts Medicare assignment. Licensed in Florida and North Carolina.

Years since qualifying
9
Licensed in
FL, NC
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2776 Cleveland Ave
Fort Myers, FL 33901
Phone: (239) 343-2606
Fax: (239) 343-3695
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-10430 (NC)
Physician Assistant Taxonomy 363A00000X · Licence PA9110602 (FL)

Record details

NPI number1538678248
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedSeptember 26, 2017
Last updated in NPPESNovember 13, 2024
Certification dateNovember 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Wake Emergency Physicians Pa — 273 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Fort Myers