Jason Bruce Black, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

007628 Issued in AZ

Practice address

801 Ostrum St
Bethlehem, PA 18015-1000

Phone

(814) 806-8450

NPI assigned

Jun 4, 2014

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 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

Emergency Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utah Emergency PhysiciansGroup PAC ID 1153307277, 151 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
• Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061

Merit-based Incentive Payment System (MIPS)

Final score

89.98 of 100Reported as group

Quality

85.2

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Utah Emergency Physicians

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1588048979
  Medicare reassignment Care Compare group NPD
• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment
• Ihc Health Services Inc

  • Diagnostic Radiology Physician
  • Cedar City, UT
  • NPI 1346896768
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Crum,Stefanko and Jones LTD

  • Emergency Medicine Physician
  • Elko, NV
  • NPI 1285645515
  NPD (past)

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

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Layton, UT
  • NPI 1417460205
  Care Compare affiliation

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1982017232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 HILL DR",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036140",
            "telephone_number": "814-806-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "814-806-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JASON",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS017853",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "007628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411971",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Birchler
• Jessie Lynn Birckhead, LCSW
• Ian Birky, PH.D.
• Alexis Bishop, CRNA
• Susan Bisio, PT
• Kimberly Sarah Blackaby, DPT
• Kimberly Blackham, PH.D., LMFT
• Nancy Jane Blaha, LCSW BCD
• Britani Blahoski, RN
• Patrick T Blanchfield, M.D.

• Emergency Medicine Physician in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.