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Dr. Conner James Black , PhD

Psychologist β€’ Riverside, RI

Active NPI 1700652948 Individual Practitioner Male Practitioner
Practice location in NPPES

1011 Veterans Memorial Pkwy
Riverside, RI 029155061

Call 4014321000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1011 Veterans Memorial Pkwy

Riverside, RI 029155061

Telephone 4014321000
Fax 4014321500
Organization at the Same NPPES Address or Phone
Emma Pendleton Bradley Hospital Facility NPI 1164627352

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Black has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Black as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Riverside and Rhode Island

9 active clinicians are listed under Psychologist with a practice address in Riverside, RI (245 in Rhode Island).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-09-16
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES RI PS02300

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Psychologist

NUCC Taxonomy Code: 103T00000X

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Rhode Island State Medical Licensing Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - CLINICAL PSYCHOLOGIST

Medicare Enrollment ID

I20241008003745

Enrollment State Jurisdiction

RI

PECOS Control ID

6406387992

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

19 listed
Dr. Bekir Artukoglu , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1114554367

Doctor of Medicine (M.D.)

NPI 1851448377

Licensed Independent Clinical Social Worker

Dr. Qiyi He , MD

Student in an Organized Health Care Education/Training Program

NPI 1437735818

Doctor of Medicine (M.D.)

Dr. Jeffrey Hunt , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1952357998

Doctor of Medicine (M.D.)

Dr. Margaret Klitzke , DO

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1770539728

Doctor of Osteopathic Medicine (D.O.)

Dr. Stacey-Ann Miller , MD, MPH

Psychiatry & Neurology - Psychiatry

NPI 1245804939

Doctor of Medicine (M.D.), Master of Public Health

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Updated Practice Location September 16, 2024

Registered at 1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 029155061 (Tel: 4014321000)

βœ…
NPI Profile Active November 29, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) November 29, 2023

Registered at 21 BLOOMINGDALE RD, WHITE PLAINS, NY 106051504 (Tel: 6468951099)

πŸ“
Business Mailing Address (Initial Record) November 29, 2023

Registered at 21 BLOOMINGDALE RD, WHITE PLAINS, NY 106051504

πŸ‘€
Provider Name / Credentials (Initial Record) November 29, 2023

Recorded as CONNER BLACK, PHD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 29, 2023

Psychologist

🟒
Initial NPI Registration & Enumeration November 29, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1700652948
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 29, 2023
Last Update: September 16, 2024
Sole Proprietor: No

Mailing Address

21 Bloomingdale Rd

White Plains, NY 106051504

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.