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MR. CARL BLACK JR. PA-C
NPI 1336723840
Physician Assistant - Medical in Philadelphia, PA

Active since May 11, 2021PECOS EnrolledAccepts Medicare Assignment
1216 E HUNTING PARK AVE, PHILADELPHIA, PA 19124(215) 533-1333(215) 744-4324 Get Directions Write a Review

NPPES record last updated: May 11, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Carl Black Jr. Pa-c NPPES

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

MR. CARL BLACK JR. PA-C (NPI 1336723840) is an individual medical provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (OA005627) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Philadelphia, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1336723840
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. CARL BLACK JR.Credential: PA-C
Location Address1216 E HUNTING PARK AVEPhiladelphia, PA 19124-4928
Mailing Address1216 E Hunting Park AvePhiladelphia, PA 19124-4928 · (215) 533-1333 · Fax (215) 744-4324
Phone(215) 533-1333
Fax(215) 744-4324
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMay 11, 2021
NPPES CertifiedMay 11, 2021
✔ NPI 1336723840 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in PA · OA005627
1216 E HUNTING PARK AVE, Philadelphia, PA 19124
Open in Google Maps ↗

Secondary Practice Location 1

Location 11909 E Washington LnPhiladelphia, PA 19138-1229 · Phone (215) 549-5900 · Fax (215) 548-8886

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Carl Black Jr. Pa-c 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 ID8729488432
PECOS Enrollment IDI20210617001972
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
125 services70 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
49 services37 patients

Other Providers at the Same Location NPPES 7

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

DR. KENNETH WISEMAN DO
Family Medicine
1216 E HUNTING PARK AVE
PHILADELPHIA, PA 19124
Philadelphia County (215) 533-1333
ENRIQUE LEONARDO III CDCES
Health and Wellness Coach
1216 E HUNTING PARK AVE
PHILADELPHIA, PA 19124
Philadelphia County (215) 533-1333
HEALTH BRIDGE MANAGEMENT
Chiropractor
1216 E HUNTING PARK AVE
PHILA, PA 19124
Philadelphia County (267) 672-1262
CHARLES MICHAEL SNOVER JR. PA-C
Physician Assistant (Medical)
1216 E HUNTING PARK AVE
PHILADELPHIA, PA 19124
Philadelphia County (215) 533-1333
EUSEBIO R. NUNEZ MD PC
Physical Medicine & Rehabilitation
1216 E HUNTING PARK AVE
PHILADELPHIA, PA 19124
Philadelphia County (215) 533-2407
MICHAEL DANIEL GONZON D.C.
Chiropractor
1216 E HUNTING PARK AVE, 2ND FLOOR
PHILADELPHIA, PA 19124
Philadelphia County (267) 672-1262
COMPLETE PHYSICIAN SERVICES
Family Medicine
1216 E HUNTING PARK AVE
PHILADELPHIA, PA 19124
Philadelphia County (215) 533-1333

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 Carl Black's NPI number?

The NPI number for Carl Black is 1336723840. It was assigned to this individual provider in the NPPES registry on May 11, 2021.

Where is Carl Black located?

Carl Black practices at 1216 E Hunting Park Ave, Philadelphia, PA 19124. The listed phone number is (215) 533-1333.

What is Carl Black's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Carl Black enrolled in Medicare?

Yes. Carl 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.

When was this NPI record last updated?

The NPPES record for Carl Black was last updated on May 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.