Robert D Dvorak

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

491 Issued in ND

Practice address

1401 13TH Ave E
West Fargo, ND 58078-3468

Phone

(701) 364-0060

Fax

(701) 364-0065

NPI assigned

Jan 24, 2014

Last updated

Jan 24, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Live Oak Behavioral Health PAGroup PAC ID 9032525969, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Live Oak Behavioral Health PA

  dba Live Oak Behavioral Health

  • Cognitive & Behavioral Psychologist
  • Maitland, FL
  • NPI 1508368192
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1437572534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 13TH AVE E",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783468",
            "telephone_number": "701-364-0060",
            "fax_number": "701-364-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 13TH AVE E",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783468",
            "telephone_number": "701-364-0060",
            "fax_number": "701-364-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORAK",
        "first_name": "ROBERT",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherry Drake
• Jenna Drayton
• Aimee Duciaume
• Leya Durgin
• Sarah Dutt, LMT, LR
• John Gregory Dye, O.D.
• Anna Dyk, OT
• Paige Earnest
• Mikenzie Eckroth, LCSW
• Jill L Ehrmantraut, PT, DPT

• Clinical Psychologist in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Clinical Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.