Individual provider Active NPI

Brandon Pat Bates, PSY.D.

  • Clinical Psychologist
  • Graham, TX
National Provider Identifier
1508824707
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
32233 Issued in TX
Practice address
617 3Rd St
Graham, TX 76450-3101
Phone
(940) 549-2259
Fax
(940) 549-2886
NPI assigned
May 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 32233 TX Primary
Clinical Psychologist 103TC0700X 954 OK

Addresses

Primary practice location

617 3Rd St
Graham, TX 76450-3101

Mailing address

617 3Rd St
Graham, TX 76450-3101
Phone (940) 549-2259

Other identifiers 3

IdentifierTypeStateIssuer
87205AOtherTXBLUE CROSS BLUE SHIELD
274009OtherTXCOMPSYCH
9428355OtherTXPHCS

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
I20061117000397 TX Practitioner - Clinical Psychologist 8527071612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bates Psychological Services PLLCGroup PAC ID 6709899891, 2 clinicians

Practice addresses (Care Compare)

617 3Rd St
Graham, TX 76450-3101
Phone (940) 549-2259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bates Psychological Services, PLLC Clinical CurrentSince May 1, 2006 Accepting new patients

Locations

617 3rd St
Graham, TX 76450
Phone (940) 549-2259

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508824707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 3RD ST",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764503101",
            "telephone_number": "940-549-2259",
            "fax_number": "940-549-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 3RD ST",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764503101",
            "telephone_number": "940-549-2259",
            "fax_number": "940-549-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "BRANDON",
        "middle_name": "PAT",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "32233",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "954",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "87205A",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "274009",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9428355",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Graham, TX

Sources for this page

Verify at the official NPI Registry.