Individual provider Active NPI

Samuel D Brinkman, PH.D.

  • Clinical Neuropsychologist
  • Abilene, TX
National Provider Identifier
1295715829
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
2-2703 Issued in TX
Practice address
1150 Estates Dr
Suite a
Abilene, TX 79602-4295
Phone
(325) 677-3172
NPI assigned
Jan 19, 2006
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
Clinical Neuropsychologist 103G00000X 2-2703 TX Primary

Addresses

Primary practice location

1150 Estates Dr
Suite a
Abilene, TX 79602-4295

Mailing address

1150 Estates Dr
Suite a
Abilene, TX 79602-4295
Phone (325) 677-3172

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
I20040729001274 TX Practitioner - Clinical Psychologist 3779553318 Practice locations: Abilene, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4755 Hartford St
Abilene, TX 79605-4604
Phone (325) 677-3172

Merit-based Incentive Payment System (MIPS)

Final score
24.72 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
82.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2-2703TXMDClinical Neuropsychologist
22703TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Neurology Clinic PC Clinical Neuropsychologist Past Accepting new patients

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295715829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 ESTATES DR",
            "address_2": "SUITE A",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796024295",
            "telephone_number": "325-677-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 ESTATES DR",
            "address_2": "SUITE A",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796024295",
            "telephone_number": "325-677-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKMAN",
        "first_name": "SAMUEL",
        "middle_name": "D",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "2-2703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.