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Breanna Bradley Black , PA-C

Physician Assistant β€’ Provo, UT

Active NPI 1346972502 Individual Practitioner Female Practitioner
Practice location in NPPES

1055 N 500 W Bldg A
Provo, UT 846043305

Call 8018125033 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

1055 N 500 W Bldg A

Provo, UT 846043305

Telephone 8018125033
Fax 8014180941
Organization at the Same NPPES Address or Phone
Central Utah Clinic, P.c. Facility NPI 1023251204

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

Open Payments general payments, program year 2025

All general payments: $117.12 across 6 records.

By nature of payment

  • Food and Beverage: $117.12 across 6 records.

Reporting-company totals (3 largest of 5)

  • Collegium Pharmaceutical, Inc.: $39.91 across 2 records.
  • ABBVIE INC.: $25.44 across 1 record.
  • ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.): $20.44 across 1 record.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).

Guide: How to read an Open Payments record

NPI first issued

2022

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)

Breanna 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 Breanna Black as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services 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 Provo and Utah

147 active clinicians are listed under Physician Assistant with a practice address in Provo, UT (1,887 in Utah).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Provo

19% of these 147 clinicians have the CMS telehealth indicator.

76.9% of these 147 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2025
Disclosure Year:

Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $117.12.

Manufacturer Payment Nature Product Type Amount ($)
ABBVIE INC.
Food and Beverage
In-kind items and services
VRAYLAR General $25.44
Collegium Pharmaceutical, Inc.
Food and Beverage
Cash or cash equivalent
Jornay PM General $21.48
ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.)
Food and Beverage
In-kind items and services
CAPLYTA General $20.44
Collegium Pharmaceutical, Inc.
Food and Beverage
Cash or cash equivalent
Jornay PM General $18.43
Analog Devices Inc.
Food and Beverage
Cash or cash equivalent
Sensinel CPM Wearable General $17.71
Corium, LLC
Food and Beverage
In-kind items and services
Azstarys General $13.62

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-10-03
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES UT 13603008-1206

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

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: Utah Division of Professional Licensing.
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 - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20231018003388

Enrollment State Jurisdiction

UT

PECOS Control ID

3577918044

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) 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.

40 listed
Jason Allen , PA

Physician Assistant

NPI 1134662729

Physician Assistant

Dr. Mohammad Alsolaiman , MD

Internal Medicine - Gastroenterology

NPI 1215986484

Doctor of Medicine (M.D.)

Kristi Anderson , FNP-C

Nurse Practitioner - Family

NPI 1235741042

Family Nurse Practitioner (Certified)

Michael Anderson , PA

Physician Assistant

NPI 1023569241

Physician Assistant

Ryan Baker , PA-C

Physician Assistant

NPI 1912306432

Physician Assistant (Certified)

Dr. Derek Bergeson , MD

Radiology - Diagnostic Radiology

NPI 1164641387

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

10 Historical Events
πŸ“
Updated Practice Location October 03, 2023

Registered at 1055 N 500 W BLDG A, PROVO, UT 846043305 (Tel: 8018125033)

πŸ“
Updated Business Mailing Address October 03, 2023

Registered at 1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 846043305 (Tel: 8013548225)

πŸ‘€
Provider Name / Credentials Updated October 03, 2023

Recorded as BREANNA BLACK, PA-C

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 03, 2023

Physician Assistant (license number reported to NPPES: UT 13603008-1206)

βœ…
NPI Profile Active June 27, 2022

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 27, 2022

Registered at 1341 S 1100 E, SPANISH FORK, UT 846605929 (Tel: 2082402967)

πŸ“
Business Mailing Address (Initial Record) June 27, 2022

Registered at 1341 S 1100 E, SPANISH FORK, UT 846605929 (Tel: 2082402967)

πŸ‘€
Provider Name / Credentials (Initial Record) June 27, 2022

Recorded as BREANNA BLACK

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 27, 2022

Physician Assistant

🟒
Initial NPI Registration & Enumeration June 27, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1346972502
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 27, 2022
Last Update: October 03, 2023
Sole Proprietor: No

Other Physician Assistants in Provo

All Physician Assistants in Provo

Mailing Address

1055 N 500 W, Attn Credentialing

Provo, UT 846043305

Phone: 8013548225

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.