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Aaliyah Jordan Black , PA-C

Physician Assistant β€’ Hebron, CT

Active NPI 1205677291 Individual Practitioner Female Practitioner
Practice location in NPPES

21 Liberty Dr
Hebron, CT 06248

Call 8602289300 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

21 Liberty Dr

Hebron, CT 06248

Telephone 8602289300
Fax 8602284703
Organization at the Same NPPES Address or Phone
Dr.amitabh R. Ram Md Llc Facility NPI 1730399379

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

NPI first issued

2024

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Hebron and Connecticut

2 active clinicians are listed under Physician Assistant with a practice address in Hebron, CT (2,047 in Connecticut).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-07-02
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Connecticut Department of Public Health Verification.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location July 02, 2026

Registered at 21 LIBERTY DR, HEBRON, CT 06248 (Tel: 8602289300)

πŸ“
Updated Business Mailing Address July 02, 2026

Registered at 41 MASSABESIC DR, AUBURN, NH 030323167 (Tel: 8602289300)

πŸ‘€
Provider Name / Credentials Updated July 02, 2026

Recorded as AALIYAH BLACK, PA-C

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 02, 2026

Physician Assistant

βœ…
NPI Profile Active June 04, 2024

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 04, 2024

Registered at 588 LONGMEADOW ST, LONGMEADOW, MA 011062292 (Tel: 4135651000)

πŸ“
Business Mailing Address (Initial Record) June 04, 2024

Registered at 588 LONGMEADOW ST, LONGMEADOW, MA 011062292 (Tel: 4135651000)

πŸ‘€
Provider Name / Credentials (Initial Record) June 04, 2024

Recorded as AALIYAH BLACK

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 04, 2024

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration June 04, 2024

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1205677291
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 04, 2024
Last Update: July 02, 2026
Sole Proprietor: Yes

Mailing Address

41 Massabesic Dr

Auburn, NH 030323167

Phone: 8602289300

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.