Active NPI
Joseph S Black, PHD
- Clinical Psychologist
- Pittsburgh, PA
National Provider Identifier
1841609740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS017631
- Practice address
- 4 Allegheny Ctr FL 8
Pittsburgh, PA 15212-5255 - Phone
- (412) 330-4000
- Fax
- (412) 330-4366
- NPI assigned
- Aug 5, 2014
- Last updated
- Jan 16, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS017631 | PA | Primary |
Addresses
Primary practice location
4 Allegheny Ctr FL 8
Pittsburgh, PA 15212-5255
Mailing address
4 Allegheny Ctr FL 8
Pittsburgh, PA 15212-5255
Phone (412) 330-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103054080 | Medicaid | PA |
Other names 1
- Audie Black
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2023 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Idaho Neuropsychology, PLLC | Clinical | Current | Accepting new patients |
Locations
1305 S Five Mile Rd
Boise, ID 83709
Phone (208) 327-0066
Organizations & group practices 1
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.
-
- Clinical Neuropsychologist
- Boise, ID
- NPI 1750257184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484524800000",
"number": "1841609740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 ALLEGHENY CTR FL 8",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152125255",
"telephone_number": "412-330-4000",
"fax_number": "412-330-4366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 ALLEGHENY CTR FL 8",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152125255",
"telephone_number": "412-330-4000",
"fax_number": "412-330-4366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "JOSEPH",
"middle_name": "S",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-05",
"last_updated": "2017-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS017631",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103054080",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AUDIE",
"last_name": "BLACK",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.