Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Joshua Phillip Black, PA-C

Individual provider Physician Assistant · NPI 1922714104

Mr. Joshua Phillip Black, PA-C is a Physician Assistant in Idaho Falls, Idaho. Qualified in 2022, 4 years ago. Practices with Steele Lake Specialty PLLC, a 19-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
4
Licensed in
ID
In the registry since
2023
Specialties on file
2
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

740 S Woodruff Ave
Idaho Falls, ID 83401-5285
Phone: (208) 542-9111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7017 Daisy Ln, Idaho Falls, ID 83402-5753 — (208) 534-5878

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-2447 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA-2447 (ID)

Record details

NPI number1922714104
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJanuary 30, 2023
Last updated in NPPESJanuary 30, 2023
Certification dateDecember 8, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Steele Lake Specialty Pllc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Idaho Falls