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

Michael Vincent Black, PA-C, ATC

Individual provider Athletic Trainer · NPI 1376016873

Michael Vincent Black, PA-C, ATC is a Physician Assistant in New York, New York. Qualified in 2019, 7 years ago. Practices with Lawrence V Gulotta MD PC, a 2-clinician group and works from 3 locations. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

541 E 71st St Fl 1
New York, NY 10021-4871
Phone: (646) 797-8735
Fax: (646) 797-8726
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 535 E 70th St, New York, NY 10021-4823 — (646) 797-8735
  • 1133 Westchester Ave, White Plains, NY 10604-3516 — (646) 797-8735

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 023345 (NY)
Athletic Trainer Taxonomy 2255A2300X · Licence 002248 (NY)

Record details

NPI number1376016873
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C , ATC
Sole proprietorNo
NPI enumeratedJanuary 7, 2019
Last updated in NPPESNovember 1, 2024
Certification dateNovember 1, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Lawrence V. Gulotta Md Pc — 2 clinicians
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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