Individual provider Active NPI

Rebecca Ann Kraatz, PH.D.

  • Psychologist
  • Portland, TX
National Provider Identifier
1285773184
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
33490 Issued in TX
Practice address
118 Sabine St
Portland, TX 78374-1454
Phone
(361) 643-6213
Fax
(361) 643-1263
NPI assigned
Feb 6, 2007
Last updated
Sep 18, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 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 33490 TX Primary

Addresses

Primary practice location

118 Sabine St
Portland, TX 78374-1454

Mailing address

118 Sabine St
Portland, TX 78374-1454
Phone (361) 643-6213

Other identifiers 2

IdentifierTypeStateIssuer
33490OtherTXPROVISIONAL LICENSE
51382OtherNATL. REGISTER PSYCHOLOGY

Other names 1

  • Dr. Rebecca Ann Kraatz P.L.L.C. Professional name

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
I20080109000118 TX Practitioner - Clinical Psychologist 2860455953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.17 of 100Reported as group
Quality
83.48
Improvement activities
40
Cost
67.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33490TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Geriatric Services P C CurrentSince Aug 9, 2021 Accepting new patients
Coastal Plains Community MHMR Center CurrentSince Oct 1, 2007 Accepting new patients
Coastal Plains Community MHMR Center CurrentSince Oct 1, 2007 Accepting new patients
Deer Oaks Mental Health Associates PC Past Accepting new patients
Coastal Plains Community MHMR Center Past Accepting new patients

Locations

200 Marriott Dr
Portland, TX 78374
Phone (361) 777-3991

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1285773184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 SABINE ST",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783741454",
            "telephone_number": "361-643-6213",
            "fax_number": "361-643-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 SABINE ST",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783741454",
            "telephone_number": "361-643-6213",
            "fax_number": "361-643-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAATZ",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "33490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVISIONAL LICENSE",
            "identifier": "33490",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATL. REGISTER PSYCHOLOGY",
            "identifier": "51382",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "KRAATZ P.L.L.C.",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Portland, TX

Sources for this page

Verify at the official NPI Registry.