Individual provider Active NPI

Richard Paul Yurcheshen, PH.D.

  • Psychologist
  • San Antonio, TX
National Provider Identifier
1104974773
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
21782 Issued in TX
Practice address
6391 De Zavala Rd Ste 203C
San Antonio, TX 78249-2159
Phone
(210) 734-6668
Fax
(210) 734-6660
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 21782 TX Primary

Addresses

Primary practice location

6391 De Zavala Rd Ste 203C
San Antonio, TX 78249-2159

Mailing address

6391 De Zavala Rd Ste 203C
San Antonio, TX 78249-2159
Phone (210) 734-6668

Other identifiers 1

IdentifierTypeStateIssuer
00JC51OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120405000417 TX Practitioner - Clinical Psychologist 7517128242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4211 Rustic MDWS
San Antonio, TX 78249-1467
Phone (210) 734-6668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
21782TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
R. P. Yurcheshen, PH.D., P.C. CurrentSince Apr 1, 1984 Accepting new patients

Locations

6391 De Zavala Rd
Ste 203C
San Antonio, TX 78249
Phone (210) 734-6668

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104974773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6391 DE ZAVALA RD STE 203C",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492159",
            "telephone_number": "210-734-6668",
            "fax_number": "210-734-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6391 DE ZAVALA RD STE 203C",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492159",
            "telephone_number": "210-734-6668",
            "fax_number": "210-734-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YURCHESHEN",
        "first_name": "RICHARD",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "21782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00JC51",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.