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KEVIN ZACHARY BLACK
NPI 1285256909
Orthopaedic Surgery in Effingham, IL

Active since May 15, 2020PECOS EnrolledAccepts Medicare Assignment
1303 W EVERGREEN AVE STE 200, EFFINGHAM, IL 62401(217) 342-3400(217) 342-6417 Get Directions Write a Review

NPPES record last updated: August 14, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 14, 2026, Jun 18, 2025, May 15, 2020 (3 updates tracked since 2020).

About Kevin Zachary Black NPPES

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

KEVIN ZACHARY BLACK (NPI 1285256909) is an individual orthopaedic surgery provider in Effingham, Illinois, licensed in Illinois (036181434) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS, is affiliated with Carilion Medical Center, and is a graduate of Wayne State University School Of Medicine (2020).

NPPES Registry Identity

NPI1285256909
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameKEVIN ZACHARY BLACK
Location Address1303 W EVERGREEN AVE STE 200Effingham, IL 62401-1638
Mailing AddressPo Box 372Mattoon, IL 61938-0372
Phone(217) 342-3400
Fax(217) 342-6417
Sole ProprietorNo
Medical School CMSWayne State University School Of MedicineGraduated 2020
Enumeration DateMay 15, 2020
Last NPPES UpdateAugust 14, 20263 updates tracked since enumeration
NPPES CertifiedAugust 14, 2026
✔ NPI 1285256909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in IL · 036181434
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1303 W EVERGREEN AVE STE 200, Effingham, IL 62401
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin Zachary Black is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507287182
PECOS Enrollment IDI20250729003623
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 Reassignments

4

Medicare enrollment records show Kevin Black reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sarah Bush Lincoln Health Center
29 mi
Family Medicine
1000 HEALTH CENTER DR
Mattoon, IL 61938
  • Reassigned Medicare billing, Illinois enrollment
  • 652 clinicians in this Medicare group
NPI 1568581379 (217) 258-2525
Carilion Rockbridge Community Hospital
419 mi
Rural Health
3 WESTWOOD MEDICAL PARK
Bluefield, VA 24605
  • Reassigned Medicare billing, Virginia enrollment
  • 507 clinicians in this Medicare group
NPI 1831589480 (276) 988-8850
Carilion Healthcare Corporation
486 mi
Multi-Specialty
213 S JEFFERSON ST STE 1006
Roanoke, VA 24011
  • Reassigned Medicare billing, Virginia enrollment
  • 956 clinicians in this Medicare group
NPI 1447206370 (540) 224-5452
Carilion Medical Center
486 mi
Dental
2017 JEFFERSON ST SW
Roanoke, VA 24014
  • Reassigned Medicare billing, Virginia enrollment
  • 1,207 clinicians in this Medicare group
NPI 1114399276 (540) 981-7128

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Carilion Medical Center

Acute Care Hospitals · Roanoke, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490024
Location1906 Belleview Avenue, SERoanoke, VA 24014 · Roanoke City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

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

FRANK S LEE M.D.
Orthopaedic Surgery
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Effingham County (217) 342-3400
JOSEPH M AJDINOVICH MD
Orthopaedic Surgery
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Effingham County (217) 342-3400
MRS. STACIA A DENNISON FNP-BC
Nurse Practitioner (Family)
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Effingham County (217) 342-3400
TIMOTHY J GRAY M.D.
Orthopaedic Surgery
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Effingham County (217) 342-3400
KAYLA R DETERS APN, FNP-BC
Nurse Practitioner (Family)
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Effingham County (217) 342-3400
DR. DIDI OMIYI M.D.
Orthopaedic Surgery
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Effingham County (217) 342-3400
MR. EVAN CHRISTOPHER HAKMAN
Physician Assistant
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Effingham County (217) 342-3400
NICKOLAS A WILLIAMS PA-C
Physician Assistant
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Effingham County (217) 342-3400

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 Kevin Black's NPI number?

The NPI number for Kevin Black is 1285256909. It was assigned to this individual provider in the NPPES registry on May 15, 2020.

Where is Kevin Black located?

Kevin Black practices at 1303 W Evergreen Ave Ste 200, Effingham, IL 62401. The listed phone number is (217) 342-3400.

What is Kevin Black's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Kevin Black enrolled in Medicare?

Yes. Kevin Black is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kevin Black's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Black reassigns Medicare benefits to 4 organizations: Sarah Bush Lincoln Health Center (Mattoon, IL), Carilion Rockbridge Community Hospital (Bluefield, VA), Carilion Healthcare Corporation (Roanoke, VA) and Carilion Medical Center (Roanoke, VA). Each 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 Kevin Black's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Black accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Kevin 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.

Is Kevin Black affiliated with any hospitals?

According to CMS data, Kevin Black is affiliated with Carilion Medical Center.

When was this NPI record last updated?

The NPPES record for Kevin Black was last updated on August 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.