Carl M Black, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4737479-1205 Issued in UT

Practice address

1034 N 500 W
Provo, UT 84604-3380

Phone

(801) 357-4423

Fax

(801) 357-7626

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Diagnostic Radiology

Education

George Washington University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Utah Valley Radiology Associates IncGroup PAC ID 1759286990, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
• American Fork Hospital Hospital, American Fork, UT, CCN 460023
• Park City Hospital Hospital, Park City, UT, CCN 460057
• Intermountain Health Heber Valley Hospital Hospital, Heber City, UT, CCN 461307
• Intermountain Health Sanpete Valley Hospital Hospital, Mount Pleasant, UT, CCN 461303

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15493/brand/1/csg/1/fhir/r4

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.

• Utah Valley Radiology Associates Inc

  • Diagnostic Radiology Physician
  • Provo, UT
  • NPI 1265483598

  UT

  Medicare reassignment Care Compare group
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880

  UT

  Medicare reassignment NPD
• St. George Radiology Inc.

  • Diagnostic Radiology Physician
  • St George, UT
  • NPI 1790736130

  Diagnostic Radiology, UT

  Medicare reassignment NPD
• Bakorp, L.L.C.

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • West Valley, UT
  • NPI 1023357894
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Fillmore, UT
  • NPI 1851338495
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • Ogden, UT
  • NPI 1144802802
  NPD
• Ihc Health Services Inc

  • Diagnostic Radiology Physician
  • Provo, UT
  • NPI 1003291568

  Diagnostic Radiology

  NPD (past)
• Intermountain Vein Center

  • Specialist
  • Provo, UT
  • NPI 1104959758
  NPD (past)
• Riverwoods Urgent Care Center LC

  • Emergency Medicine Physician
  • Provo, UT
  • NPI 1801894035
  NPD (past)
• Tooele Valley Imaging, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Tooele, UT
  • NPI 1699004499
  NPD (past)
• Ubmc Anesthesiology

  • Certified Registered Nurse Anesthetist
  • Roosevelt, UT
  • NPI 1043643877
  NPD (past)

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

• Ihc Health Services Inc

  • Critical Access Hospital
  • Heber City, UT
  • NPI 1316055205

  Hospital

  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Park City, UT
  • NPI 1851530984

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Provo, UT
  • NPI 1114025491

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • Critical Access Hospital
  • Mt Pleasant, UT
  • NPI 1407964398

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • Infusion Therapy Clinic/Center
  • Spanish Fork, UT
  • NPI 1679426944

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • American Fork, UT
  • NPI 1912014358

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • Infusion Therapy Clinic/Center
  • American Fork, UT
  • NPI 1982557252

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1891737094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "801-351-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-357-4423",
            "fax_number": "801-357-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CARL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "4737479-1205",
            "primary": true
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "UT",
            "license": "4737479-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMIA",
            "identifier": "870284448CB1",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "47374791204001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "666798",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107008883101",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Halle Jane Bjerregaard
• Daniel Kent Bjornn
• Alyssa Nichole Black
• Breanna Bradley Black, PA-C
• Brent Black
• Catherine R Black
• Christine Warner Black
• Jackie Evans Black, RN
• Kendra Black
• Lindsay Black

• All providers in Provo, UT
• Diagnostic Radiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.