Individual provider

Kaelan Black, M.D.

Pediatric Otolaryngology Physician Medicare enrolled

Kaelan Black, M.D. is a Pediatric Otolaryngology Physician in Fairfax, VA, registered under NPI 1215226469.

Getting there

The practice address on file is 3801 UNIVERSITY DR STE 300, Fairfax, VA 22030. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

3801 UNIVERSITY DR STE 300, Fairfax, VA 22030 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
0101263011 VA Pediatric Otolaryngology Physician primary
MD223309 OR Pediatric Otolaryngology Physician

Licences are recorded in 2 states: VA, OR. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Otolaryngology
PAC ID
8426314881

Enrolled in Medicare 3 times, across 3 states:

StateEnrollment IDProvider type
District of Columbia I20171117002185 Practitioner - Otolaryngology
Virginia I20171204002410 Practitioner - Otolaryngology
Oregon I20250116003757 Practitioner - Pediatric Medicine

Medicare enrolment is recorded as approved under the provider type Practitioner - Otolaryngology. There are 3 separate enrolment records across 3 states (DC, VA, OR). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Oregon and Virginia. The practice address on file is in Fairfax, VA, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

OR Oregon
Licence
MD223309
Specialty
Pediatric Otolaryngology Physician
Verify with the OR board →
VA Virginia practice address
Licence
0101263011
Specialty
Pediatric Otolaryngology Physician
Verify with the VA board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Pediatric Otolaryngology covers

A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. NUCC Health Care Provider Taxonomy, code 207YP0228X
Allopathic & Osteopathic Physicians Otolaryngology Pediatric Otolaryngology

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
207YP0228X Pediatric Otolaryngology Physician Pediatric Otolaryngology 0101263011 VA primary
207YP0228X Pediatric Otolaryngology Physician Pediatric Otolaryngology MD223309 OR

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1215226469 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateMar 28, 2011
Last updatedAug 29, 2025
StatusActive
Sole proprietorNo
CredentialM.D.
Practice address 3801 UNIVERSITY DR STE 300
Fairfax, VA 22030
(703) 383-8130
Fax (703) 383-7350
Mailing address 3801 UNIVERSITY DR STE 200
Fairfax, VA 22030
This record was updated on Aug 29, 2025, which is recent enough that the contact details are likely still accurate.

Number check

1215226469 passes the NPI check digit test The final digit 9 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 2 1 5 2 2 6 4 6
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 2 2 5 4 2 3 4 3

Sum = 51 · next multiple of 10 = 60 · check digit = 9 · actual last digit = 9

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1215226469?
NPI 1215226469 is the National Provider Identifier assigned to Kaelan Black, M.D. in Fairfax, VA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Pediatric Otolaryngology cover?
A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in…
How do I contact Kaelan Black, M.D.?
The phone number on file with NPPES is (703) 383-8130, last updated Aug 29, 2025. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Kaelan Black, M.D. accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1215226469 a valid number?
Yes. 1215226469 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.