STACEY RAE BLACK (MD) – Diagnostic Radiology Physician, NPI 1336291038
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
134 INTERVENTIONAL RADIOLOGY in TN
Provider Addresses for STACEY RAE BLACK (MD)
1800 W CHARLESTON BLVD
LAS VEGAS, NV 891022386
Phone: (702) 383-2000
Type: Mailing
990 Oak Ridge Tpke
Oak Ridge, TN 378306976
Phone: (866) 730-5619
Type: Location
601 DODDS AVE
CHATTANOOGA, TN 374043911
Phone: (866) 730-5619
Fax: (423) 698-3622
Type: Mailing
2492, East River Road, Catalina Foothills, Tucson, Pima County, Arizona, 85718, United States
TUCSON, AZ 857189552
Phone: (520) 722-8994
Fax: (520) 624-0117
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 45 Open Payments records for all available years, with a total value of $4,559.
Total Amount is formed as General ($4,559) + Research ($0) + Ownership ($0) = $4,559.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Penumbra, Inc. ($3,634).
Total Amount
$4,559
General + Research + Ownership
Payments
45
Total payment records
General Amount
$4,559
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Penumbra, Inc. | $3,634 |
| Boston Scientific Corporation | $347 |
| Inari Medical, Inc. | $269 |
| W. L. Gore & Associates, Inc. | $159 |
| Abbott Laboratories | $108 |
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: 2023-12-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140625001719 | I | Interventional Radiology | AZ | TBD |
| I20220403000007 | I | Diagnostic Radiology | TN | TBD |
| I20230710003722 | I | Diagnostic Radiology | CA | TBD |
| I20230807004006 | I | Diagnostic Radiology | DC | TBD |
| I20231221000441 | I | Diagnostic Radiology | NV | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 224 | 214 | $0 |
| 70450 | Ct scan head or brain without contrast | 93 | 93 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 41 | 41 | $0 |
| 74176 | Ct scan of abdomen and pelvis without contrast | 40 | 40 | $0 |
| 71046 | X-ray of chest, 2 views | 39 | 39 | $0 |
Insurance plans in this area (ZIP 89102)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERVENTIONAL RADIOLOGY | AZ | 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 17 | 16 |
| INTERVENTIONAL RADIOLOGY | AZ | 77012 | Radiological supervision and interpretation of CT guidance for needle insertion | 41 | 38 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | AZ | |
| Diagnostic Radiology | VA | |
| Diagnostic Radiology | AZ | |
| Diagnostic Radiology | FL | |
| Diagnostic Radiology | AZ | |
| Diagnostic Radiology | AZ | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | AZ | |
| Interventional Radiology | AZ | |
| Diagnostic Radiology | AZ |
Reviews
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