KYLER BLACK (M.D.) – Internal Medicine Physician, NPI 1518499268

KYLER BLACK (M.D.) is a healthcare provider. based in Roosevelt, Utah. specializing in INTERNAL MEDICINE, PEDIATRIC MEDICINE. They hold the professional credentials M.D.. They hold a License No. 12304561-1205 (UT). The NPI Number for KYLER BLACK (M.D.) is 1518499268

Main info

Male
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
KYLER BLACK (M.D.)
NPI
1518499268
Phone
(435) 722-4691
Address
250 W 300 N
Enumeration Date
31 March 2017
Last Update Date
28 July 2021

Doctor Profile

Medical School Name
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Secondary Phone
4357224691
Graduation Year
2017 (9 years ago)
PAC ID
1658775622
Group Practice PAC ID
0244131944
Professional Enrollment ID
I20210812002817
Address ID
UT840662336RO250XX300X301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:9State licenses:1Digital endpointsOther names

903 INTERNAL MEDICINE in UT

Provider Addresses for KYLER BLACK (M.D.)

  • 250 W 300 N

    ROOSEVELT, UT 840662336

    Phone: (435) 722-4691

    Type: Location

  • 1111 E McDowell Rd

    Phoenix, AZ 850062612

    Phone: (602) 839-2296

    Type: Location

  • 4408, 76th Street, Quaker Heights, Lubbock, Lubbock County, Texas, 79424, United States

    LUBBOCK, TX 794243331

    Phone:

    Type: Mailing

  • Banner University Medical Center Phoenix, 1111, East McDowell Road, Phoenix, Maricopa County, Arizona, 85006, United States

    PHOENIX, AZ 850062612

    Phone: (602) 839-2296

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 27 Open Payments records for all available years, with a total value of $477.

Total Amount is formed as General ($477) + Research ($0) + Ownership ($0) = $477.

Last reported payment date: 2024-08-27 • Largest payer in this snapshot: ABBVIE INC. ($126).

Total Amount

$477

General + Research + Ownership

Payments

27

Total payment records

General Amount

$477

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-27

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2021-08-12

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
I20210812002817IInternal MedicineUTTBD

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
78452Nuclear medicine studies of heart muscle at rest and with stress and spect5959$0
93016Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician5454$0
93018Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician5454$0
View full utilization report →

Insurance plans in this area (ZIP 84066)

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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: 0244131944View full group profile
NameSpecialtyState
General SurgeryAK
Pediatric MedicineUT
Physician AssistantUT
Family PracticeUT
Nurse PractitionerUT
P A T H O L O G YIL
Family PracticeUT
Nurse PractitionerUT
O B S T E T R I C S/ G Y N E C O L O G YUT
Physician AssistantUT

Reviews

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Frequently asked questions

What is the registry number for KYLER BLACK (M.D.)?
The registry entry for KYLER BLACK (M.D.) shows NPI 1518499268.
Quick check: is KYLER BLACK (M.D.) active?
Public NPPES data shows KYLER BLACK (M.D.) with an active NPI status right now.
How should patients interpret KYLER BLACK (M.D.)'s specialty?
The extract shows Internal Medicine Physician for KYLER BLACK (M.D.). Clinical services aligned with this taxonomy classification.
What city is tied to KYLER BLACK (M.D.)?
The directory associates KYLER BLACK (M.D.) with Roosevelt, Utah. Check all listed addresses for suites or satellite offices.
Why is information missing for KYLER BLACK (M.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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