Byrl Robert Crago, PHD
Individual provider Active NPI Psychologist · Tucson, AZ
NPI 1154517233 · NPPES record last updated Mar 9, 2010
Key facts
- NPI
- 1154517233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 0866 (AZ)
- Practice address
- 5363 E Pima St Ste 100
Tucson, AZ 85712-3663 - Phone
- (520) 323-0062
- Fax
- (520) 323-1336
- NPI assigned
- Sep 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5363 E Pima St
Suite 100
Tucson, AZ 85712-3663
Phone (520) 323-0062
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050928001094 | AZ | Practitioner - Clinical Psychologist | 0143255158 |
Reassigns benefits to 1 organization Practice locations: Tucson, AZ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0866 | AZ | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| B. Robert Crago PHD PC | Current |
Accepting new patients | |
| B Robert Crago PHD PC | Psychologist | Past | Accepting new patients |
Locations
255 N Rosemont Blvd
Unit 12662
Tucson, AZ 85732
5363 E Pima St
Ste 100
Tucson, AZ 85712
Phone (520) 323-0062
5210 E Pima St
Ste 200
Tucson, AZ 85712
Phone (520) 271-6506
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0866 | AZ | Yes |
Addresses
Primary practice location
5363 E Pima St Ste 100
Tucson, AZ 85712-3663
Mailing address
5363 E Pima St Ste 100
Tucson, AZ 85712-3663
Phone (520) 323-0062
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.