DR. BENJAMIN JACOB BLACK (DPT) – Physical Therapist, NPI 1114558590

DR. BENJAMIN JACOB BLACK (DPT) is a healthcare provider. based in Louisville, Colorado. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PTL.0016752 (CO). The NPI Number for DR. BENJAMIN JACOB BLACK (DPT) is 1114558590

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. BENJAMIN JACOB BLACK (DPT)
NPI
1114558590
Phone
(303) 666-4151
Address
315 W SOUTH BOULDER RD STE 100
Enumeration Date
4 February 2020
Last Update Date
4 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3039635582
Graduation Year
2019 (7 years ago)
PAC ID
3173950599
Group Practice PAC ID
9032521448
Professional Enrollment ID
I20200225001763
Address ID
CO800272325LO1855XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

2,988 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CO

Provider Addresses for DR. BENJAMIN JACOB BLACK (DPT)

  • 315 W SOUTH BOULDER RD STE 100

    LOUISVILLE, CO 800271157

    Phone: (303) 666-4151

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-02-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200225001763IPhysical Therapist In Private PracticeCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities2,355106$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes1,66796$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes18241$0
97140Therapy procedure using manual technique, each 15 minutes17928$0
97162Evaluation for physical therapy, typically 30 minutes2121$0
View full utilization report →

Insurance plans in this area (ZIP 80027)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032521448View full group profile
NameSpecialtyState
Qualified Speech Language PathologistCA
Qualified Speech Language PathologistND
Occupational Therapist In Private PracticeCO
Occupational Therapist In Private PracticeCO
Qualified Speech Language PathologistCO
Qualified Speech Language PathologistCO
Physical Therapist In Private PracticeCO
Occupational Therapist In Private PracticeCO
Occupational Therapist In Private PracticeCO
Qualified Speech Language PathologistCO

Reviews

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Frequently asked questions

Is there an official ID for DR. BENJAMIN JACOB BLACK (DPT) in U.S. healthcare records?
The official identifier for DR. BENJAMIN JACOB BLACK (DPT) is NPI 1114558590.
Is DR. BENJAMIN JACOB BLACK (DPT) still an active registrant?
DR. BENJAMIN JACOB BLACK (DPT) carries an active NPI according to the public dataset.
What kind of doctor is DR. BENJAMIN JACOB BLACK (DPT)?
DR. BENJAMIN JACOB BLACK (DPT) is associated with Physical Therapist in the directory — Clinical services aligned with this taxonomy classification.
Is DR. BENJAMIN JACOB BLACK (DPT) associated with Louisville?
Public fields place DR. BENJAMIN JACOB BLACK (DPT) around Louisville, Colorado. Always confirm the exact site before visiting.
Can I trust this NPI listing for DR. BENJAMIN JACOB BLACK (DPT)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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