Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Carl Black Jr., PA-C

Individual provider Medical Physician Assistant · NPI 1336723840

Mr. Carl Black Jr., PA-C is a Physician Assistant in Philadelphia, Pennsylvania. Qualified in 2020, 6 years ago. Practices with Complete Physician Services, a 4-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
6
Licensed in
PA
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1216 E Hunting Park Ave
Philadelphia, PA 19124-4928
Phone: (215) 533-1333
Fax: (215) 744-4324
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1909 E Washington Ln, Philadelphia, PA 19138-1229 — (215) 549-5900

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence OA005627 (PA)

Record details

NPI number1336723840
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 11, 2021
Last updated in NPPESMay 11, 2021
Certification dateMay 11, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Complete Physician Services — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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