Samuel Jacob Black, MD, PHD - Medicare Internal Medicine in Philadelphia, PA

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Samuel Jacob Black, MD, PHD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Philadelphia, Pennsylvania. He went to Temple University School Of Medicine and graduated in 2021 and has 4 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Temple Faculty Practice Plan Inc and his current practice location is 3322 N Broad St, Philadelphia, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (215) 707-1800.

Samuel Jacob Black is licensed to practice in Pennsylvania (license number MT222514) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1124697958.

Contact Information

Samuel Jacob Black, MD, PHD
3322 N Broad St,
Philadelphia, PA 19140-5185
(215) 707-1800
Not Available

Map and Direction




Physician's Profile

Full NameSamuel Jacob Black
GenderMale
SpecialityInternal Medicine
Experience4 Years
Location3322 N Broad St, Philadelphia, Pennsylvania
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Samuel Jacob Black attended and graduated from Temple University School Of Medicine in 2021
  NPI Data:
  • NPI Number: 1124697958
  • Provider Enumeration Date: 06/24/2021
  • Last Update Date: 06/26/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 2769883495
  • Enrollment ID: I20240404000210

Medical Identifiers

Medical identifiers for Samuel Jacob Black such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124697958NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine MT222514 (Pennsylvania)Secondary
390200000XStudent In An Organized Health Care Education/training Program MT222514 (Pennsylvania)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Temple University HospitalPhiladelphia, PAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Temple Faculty Practice Plan Inc03455887111191

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samuel Jacob Black allows following entities to bill medicare on his behalf.
Entity NameTemple Faculty Practice Plan Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881176949
PECOS PAC ID: 0345588711
Enrollment ID: O20190208002623

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel Jacob Black is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Samuel Jacob Black, MD, PHD
3401 N Broad St Ste 810,
Philadelphia, PA 19140-5189

Ph: (215) 707-4085		Samuel Jacob Black, MD, PHD
3322 N Broad St,
Philadelphia, PA 19140-5185

Ph: (215) 707-1800

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.