Individual provider Active NPI

Gage Stermensky II, PSY.D., BCB

  • Psychologist
  • Scottsbluff, NE
National Provider Identifier
1336542323
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
885 Issued in NE
Practice address
1723 Avenue a
Scottsbluff, NE 69361-2446
Phone
(417) 413-0085
NPI assigned
Oct 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 885 NE Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 987 NE

Addresses

Primary practice location

1723 Avenue a
Scottsbluff, NE 69361-2446

Mailing address

1723 Avenue a
Scottsbluff, NE 69361-2446
Phone (417) 413-0085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: No
  • 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
I20151027001512 NE Practitioner - Clinical Psychologist 0749599066 Reassigns benefits to 1 organization
Practice locations: Scottsbluff, NE

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1811 Ave a
Scottsbluff, NE 69361-2448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
987NEMDRegistered Dietitian
885NEMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Action Partnership of Western Nebraska CurrentSince Oct 3, 2015 Accepting new patients
Dr. Gage Stermensky LLC Psychologist Past Accepting new patients

Locations

975 Crescent Dr
Gering, NE 69341
Phone (308) 632-2540

3350 10th St
Gering, NE 69341
Phone (308) 632-2540

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Action Partnership of Western NebraskaGering, NE, CCN 281803 Federally qualified health center Corporate Director Apr 1, 2022
Capwn Dental Clinic-ChadronChadron, NE, CCN 281817 Federally qualified health center Corporate Director Apr 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1336542323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 AVENUE A",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693612446",
            "telephone_number": "417-413-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 AVENUE A",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693612446",
            "telephone_number": "417-413-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERMENSKY",
        "first_name": "GAGE",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PSY.D., BCB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-03",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "885",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "987",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsbluff, NE

Sources for this page

Verify at the official NPI Registry.