DR. EVAN GEORGE BLACK (M.D.) – Neurology Physician, NPI 1346260247
Neurology Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. EVAN GEORGE BLACK (M.D.)
630 Eaton Ave
Hamilton, OH 450132767
Phone: (513) 867-2000
Fax: (513) 867-2119
Type: Location
1250 S Cedar Crest Blvd Ste 405
Allentown, PA 181036224
Phone: (610) 402-8420
Type: Location
11215 Metro Pkwy Ste 1
Fort Myers, FL 339661206
Phone: (239) 208-2212
Type: Location
5323, Woodrow Street, Murray, Salt Lake County, Utah, 84107, United States
#201
MURRAY, UT 841075841
Phone: (801) 261-4711
Fax: (801) 261-4769
Type: Mailing
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: 2024-02-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 6 Medicare enrollment records; no due dates published yet.
Enrollment records
6
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 |
|---|---|---|---|---|
| I20031223000339 | I | Neurology | UT | TBD |
| I20200526002814 | I | Neurology | WI | TBD |
| I20210803003530 | I | Neurology | MI | TBD |
| I20210923000845 | I | Hospitalist | GA | TBD |
| I20210929002072 | I | Psychiatry | OR | TBD |
| I20240206004916 | I | Neurology | SD | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45013)
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