Active NPI
Lewis Bank, PH.D., PSYCHOLOGIST
- Psychologist
- Bend, OR
National Provider Identifier
1407256746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 605
- Practice address
- 1345 NW Wall St Ste 303
Bend, OR 97703-1970 - Phone
- (503) 367-4042
- Fax
- (844) 269-6806
- NPI assigned
- Aug 22, 2014
- Last updated
- Sep 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 605 | OR | |
| Clinical Neuropsychologist | 103G00000X | 605 | OR | |
| Psychologist | 103T00000X | 605 | OR | Primary |
| Behavior Analyst | 103K00000X | 605 | OR |
Addresses
Primary practice location
1345 NW Wall St Ste 303
Bend, OR 97703-1970
Mailing address
1345 NW Wall St Ste 303
Bend, OR 97703-1970
Phone (503) 367-4042
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141028000620 | OR | Practitioner - Psychologist Billing Independently | 0143441576 | Practice locations: Bend, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1345 NW Wall St
Suite 303
Bend, OR 97703-1970
Phone (503) 367-4042
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 605 | OR | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downtown Psychological Services | Single Specialty | Current | Accepting new patients |
Locations
1345 NW Wall St
Ste 303
Bend, OR 97703
Phone (503) 367-4042
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, 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": "1408665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1407256746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1345 NW WALL ST STE 303",
"city": "BEND",
"state": "OR",
"postal_code": "977031970",
"telephone_number": "503-367-4042",
"fax_number": "844-269-6806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 NW WALL ST STE 303",
"city": "BEND",
"state": "OR",
"postal_code": "977031970",
"telephone_number": "503-367-4042",
"fax_number": "844-269-6806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANK",
"first_name": "LEWIS",
"credential": "PH.D., PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-22",
"last_updated": "2020-09-16",
"certification_date": "2020-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "605",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "OR",
"license": "605",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "605",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "OR",
"license": "605",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.