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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SPENCER EVAN BLACK MD
NPI 1053842914
Psychiatry & Neurology - Child & Adolescent Psychiatry in Lehi, UT

Active since March 22, 2017PECOS Enrolled
2250 N MILLER CAMPUS DR, LEHI, UT 84043(859) 313-7711(385) 531-1805 Get Directions Write a Review

NPPES record last updated: September 16, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 16, 2026, Mar 3, 2023, May 2, 2022 and 3 more (6 updates tracked since 2017).

About Spencer Evan Black Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPENCER EVAN BLACK MD (NPI 1053842914) is an individual child & adolescent psychiatry provider in Lehi, Utah, licensed in Utah (12759564-1205) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053842914
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameSPENCER EVAN BLACKCredential: MD
Location Address2250 N MILLER CAMPUS DRLehi, UT 84043-7233
Mailing Address295 S Chipeta WaySalt Lake City, UT 84108-1287 · (859) 313-7711
Phone(859) 313-7711
Fax(385) 531-1805
Sole ProprietorYes
Enumeration DateMarch 22, 2017
Last NPPES UpdateSeptember 16, 20266 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2026
✔ NPI 1053842914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in UT · 12759564-1205
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
2250 N MILLER CAMPUS DR, Lehi, UT 84043
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Spencer Evan Black Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Spencer Black reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ihc Health Services Inc
1.8 mi
Urgent Care
3249 N 1200 W
Lehi, UT 84043
  • Reassigned Medicare billing, Utah enrollment
  • Also billed through NPI 1083742589 (Utah)
  • 3,691 clinicians in this Medicare group
NPI 1164911962 (801) 234-5880

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIMOTHY FOWLES
Psychologist (Clinical)
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (801) 824-6047
DR. JACKIE MARIE NELSON PSY.D.
Psychologist (Clinical)
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (801) 662-1000
ASHLEE NICOLE SADDLER
Occupational Therapist (Mental Health)
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (801) 662-1000
ALEXANDRA WEISZ LMFT
Marriage & Family Therapist
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (801) 662-3603
STACY MICHELLE FENTON MSW
Social Worker (Clinical)
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (801) 662-3601
IHC HEALTH SERVICES, INC.
Pharmacy (Community/Retail Pharmacy)
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (435) 531-1143
MICHELLE WELLER
Speech-Language Pathologist
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (833) 577-3422
BROOKLYN KAYE SIMON OTR/L
Occupational Therapist
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (833) 577-3422

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Spencer Black's NPI number?

The NPI number for Spencer Black is 1053842914. It was assigned to this individual provider in the NPPES registry on March 22, 2017.

Where is Spencer Black located?

Spencer Black practices at 2250 N Miller Campus Dr, Lehi, UT 84043. The listed phone number is (859) 313-7711.

What is Spencer Black's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Spencer Black enrolled in Medicare?

Yes. Spencer Black is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Spencer Black's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Spencer Black reassigns Medicare benefits to Ihc Health Services Inc (Lehi, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Spencer Black's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Spencer Black accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and Select Health list Spencer Black as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Spencer Black was last updated on September 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.