Kendra Marie Black, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A176120 Issued in CA

Practice address

200 W Arbor Dr
San Diego, CA 92103-9000

Phone

(800) 926-8273

NPI assigned

Apr 14, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Regional One Health Hospital, Memphis, TN, CCN 440152

Merit-based Incentive Payment System (MIPS)

Final score

90.77 of 100Reported as group

Quality

84.13

Promoting interoperability

100

Improvement activities

40

Cost

73.88

Merit-based Incentive Payment System (MIPS)

Final score

80.97 of 100Reported as group

Quality

64.58

Improvement activities

40

Cost

77.33

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ut Regional One Physicians Inc

  • Surgery Physician
  • Memphis, TN
  • NPI 1093130585
  Medicare reassignment Care Compare group NPD
• Regents of the University of California

  • Surgery Physician
  • San Diego, CA
  • NPI 1740382993
  Medicare reassignment NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD
• Ut Regional One Physicians Inc

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1285042028
  NPD
• Shelby County Health Care Corporation

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1144213117
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shelby County Health Care Corporation

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1144213117
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1225482425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "800-926-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7900 Lees Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641391246",
            "country_code": "US",
            "telephone_number": "816-404-4862",
            "fax_number": "816-404-7716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4401 Wornall Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641113241",
            "country_code": "US",
            "telephone_number": "816-932-2107",
            "fax_number": "816-932-2843",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 Holmes St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082677",
            "country_code": "US",
            "telephone_number": "816-404-4175",
            "fax_number": "816-404-0003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KENDRA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-14",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "A176120",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A176120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Alessandra Black
• Hilary Black, RN
• Jamie Z Black, PA-C
• Jennifer Black, MD, PHARMD
• Jordan Black, M.D.
• Kimberly Black
• Kristi Black, DC
• Lori Black, RN
• Moray Black
• Peggy Sue Black, LPCC, LCPC

• Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.