Individual provider Active NPI

Jay P Bevan, PH D

  • Clinical Psychologist
  • Sugar Land, TX
National Provider Identifier
1285897223
Registry record updated Feb 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
23738 Issued in TX
Practice address
101 Southwestern Blvd
Suite 109
Sugar Land, TX 77478-3668
Phone
(281) 242-1970
NPI assigned
Jul 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 23738 TX Primary

Addresses

Primary practice location

101 Southwestern Blvd
Suite 109
Sugar Land, TX 77478-3668

Mailing address

101 Southwestern Blvd Ste 109
Sugar Land, TX 77478-3548
Phone (281) 242-1970

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
I20190513002455 TX Practitioner - Clinical Psychologist 5799027017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halverson and Bevan, PCGroup PAC ID 4688916034, 2 clinicians

Practice addresses (Care Compare)

101 Southwestern Blvd
Suite 109
Sugar Land, TX 77478-3548
Phone (281) 242-1970

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23738TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Halverson & Bevan PC Clinical CurrentSince Apr 1, 2019 Accepting new patients

Locations

101 Southwestern Blvd
Ste 109
Sugar Land, TX 77478
Phone (281) 242-1970

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549065600000",
    "number": "1285897223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SOUTHWESTERN BLVD STE 109",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783548",
            "telephone_number": "281-242-1970",
            "fax_number": "281-242-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SOUTHWESTERN BLVD",
            "address_2": "SUITE 109",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783668",
            "telephone_number": "281-242-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVAN",
        "first_name": "JAY",
        "middle_name": "P",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2019-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "23738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.