Individual provider Active NPI

Lewis Bank, PH.D., PSYCHOLOGIST

  • Psychologist
  • Bend, OR
National Provider Identifier
1407256746
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
605 Issued in OR
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, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
605ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew 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.

Verify at the official NPI Registry.