Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michael Jason Black, MD

Individual provider Surgery Physician · NPI 1720036387

Michael Jason Black, MD is a General Surgery in Appleton, Wisconsin. Graduated from Medical College of Wisconsin in 2002, 24 years ago. Practices with Fox Valley Surgical Associates Ltd, a 35-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
24
Trained at
Medical College of Wisconsin
Licensed in
WI
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2000 E Milestone Dr
Appleton, WI 54913-6701
Phone: (920) 731-8131
Fax: (920) 832-0444
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 46688-020 (WI)
Surgery Physician Taxonomy 208600000X · Licence 46688 (WI)

Record details

NPI number1720036387
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 5, 2006
Last updated in NPPESJuly 22, 2025
Certification dateJuly 22, 2025
Mailing address2000 E Milestone Dr, Appleton, WI 54913-6701

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Also practisesCOLORECTAL SURGERY (PROCTOLOGY)
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2002 (24 years in practice)
Group practice Fox Valley Surgical Associates Ltd — 35 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Appleton