Glenn Raymond Black, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

35.036808 Issued in OH

Practice address

103 5TH St SE
Ste S
Barberton, OH 44203-4256

Phone

(330) 753-5863

Fax

(330) 753-9838

NPI assigned

Dec 1, 2005

Last updated

Apr 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Ohio State University College of Medicine, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Akron General Medical Center Hospital, Akron, OH, CCN 360027
• Mercy Medical Center Hospital, Canton, OH, CCN 360070
• Summa Health System Hospital, Akron, OH, CCN 360020
• Wooster Community Hospital Hospital, Wooster, OH, CCN 360036
• Aultman Orrville Hospital Hospital, Orrville, OH, CCN 361323

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Glenn R Black MD Inc

  • Cardiovascular Disease Physician
  • Barberton, OH
  • NPI 1326253238
  Medicare reassignment NPD Authorized official

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

• Akron General Medical Center

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1821035940
  Care Compare affiliation
• City of Wooster

  dba Wooster Community Hospital

  • General Acute Care Hospital
  • Wooster, OH
  • NPI 1437156247
  Care Compare affiliation
• Cleveland Clinic Mercy Hospital

  dba Mercy Medical Center

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Care Compare affiliation
• Orrville Hospital Foundation

  dba Aultman Orrville Hospital

  • Critical Access Hospital
  • Orrville, OH
  • NPI 1891718375
  Care Compare affiliation
• Summa Health System

  dba Summa Health System Ignatia Hall South

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Canton, OH
  • NPI 1295036762

  Hospital

  Care Compare affiliation
• Summa Health System

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1396765681
  Care Compare affiliation
• Summa Health System

  • Clinical Medical Laboratory
  • Barberton, OH
  • NPI 1609263706

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1700860970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 MARINA DR",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443193424",
            "telephone_number": "330-645-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 5TH ST SE",
            "address_2": "STE S",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442034256",
            "telephone_number": "330-753-5863",
            "fax_number": "330-753-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "GLENN",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.036808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "107535",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1786246",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341397094026",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000191152",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0400075",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE COMM HEALTH PLAN",
            "identifier": "729783",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4205812",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0429549",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED MINE WORKERS",
            "identifier": "1263551",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "59634",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "791063783",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katreena Beeson, LPN
• Lindsey Berlin
• Yekalo T. Beyene, M.D.
• Karamjit Singh Bhullar, MD
• Sharon Cherop Birech, MD
• Ryan Black
• Jamair Blackmon
• Tabitha Blackmon
• Tyira Blair
• Paige Blankenship, PH.D.

• Cardiovascular Disease Physician in Barberton, OH
• Providers in Barberton, OH by specialty
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.