Kyle Joseph Black, PT

Key facts

NPI

1366968307

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

13245 (AZ)

Practice address

350 S Main St
Florence, AZ 85132-8513

Phone

(520) 868-0098

Fax

(520) 868-1098

NPI assigned

Aug 22, 2017

Sex

Male

Sole proprietor

No

Organizations & group practices 5

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.

• Affinity Physical Therapy LLC Specialist · Florence, AZ · NPI 1487751772
  Medicare reassignment NPD AZ
• Athletico LTD Physical Therapist · Oak Brook, IL · NPI 1821085028
  Medicare reassignment NPD AZ · PHYSICAL THERAPIST
• Athletico LTD Clinic/Center · Lafayette, IN · NPI 1053044867
  NPD PHYSICAL THERAPIST
• Accelerated Rehabilitation Centers of Phoenix LLC Clinic/Center · Gilbert, AZ · NPI 1033676606
  NPD (past) PHYSICAL THERAPIST
• Affinity Physical Therapy, LLC Physical Therapist · Florence, AZ · NPI 1114322807
  NPD (past) PHYSICAL THERAPIST

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTD (2,187 clinicians)

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.32 of 100 (group)

Quality

84.44

Promoting interoperability

99

Improvement activities

40

Cost

70.78

Medicare participation

Medicare fee-for-service enrollment

Enrolled in AZ

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kyle.black.p6@direct.athleticoltd.nextgenshare.com

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 17, 2018.

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1366968307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1400",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "851323028",
            "telephone_number": "520-868-1098",
            "fax_number": "520-868-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S MAIN ST",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "851328513",
            "telephone_number": "520-868-0098",
            "fax_number": "520-868-1098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21300 North John Wayne Pakway",
            "address_2": "#107",
            "address_purpose": "LOCATION",
            "city": "Maricopa",
            "state": "AZ",
            "postal_code": "85139",
            "country_code": "US",
            "telephone_number": "520-868-6100",
            "fax_number": "520-868-6106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1491 N Arizona Blvd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Coolidge",
            "state": "AZ",
            "postal_code": "851283261",
            "country_code": "US",
            "telephone_number": "520-424-2222",
            "fax_number": "520-424-2646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3930 S Alma School Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852484510",
            "country_code": "US",
            "telephone_number": "480-899-9829",
            "fax_number": "480-729-9829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3930 S Alma School Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852484510",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KYLE",
        "middle_name": "JOSEPH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "13245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE LICENSE",
            "identifier": "13245",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AZ

• Hayley Benson
• Lindsey Beus, NP-C
• Marcy L Biersack, M.A.
• David Anthony Bilsky, SLPA
• Bio-Medical Applications of Arizona, LLC
• Marion Blakely
• Danielle Brady
• Adia Brewington, SLPA
• Lindsey Brown, R.N.
• Orville Donald Brown III

All providers in Florence, AZ · Physical Therapist in Arizona