Individual provider Active NPI

Timothy Django Rogers, PSY.D.

  • Psychologist
  • Boca Raton, FL
National Provider Identifier
1760799548
Registry record updated Oct 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY9858 Issued in FL
Practice address
6909 SW 18TH St.
Boca Raton, FL 33433
Phone
(561) 218-4342
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY9858 FL Primary

Addresses

Primary practice location

6909 SW 18TH St.
Boca Raton, FL 33433

Mailing address

6909 SW 18TH St.
Suite a-203
Boca Raton, FL 33433
Phone (561) 218-4342

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180423001909 FL Practitioner - Clinical Psychologist 0941563142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Behavioral Care of North Carolina PCGroup PAC ID 5092120030, 175 clinicians

Practice addresses (Care Compare)

1090 S Tamiami TRL
Sarasota, FL 34236-9116
Phone (941) 363-0878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY9858FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of North Carolina, PC CurrentSince Feb 15, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. CurrentSince Feb 15, 2024 Accepting new patients

Locations

7451 Wiles Rd
Ste 103
Coral Springs, FL 33067
Phone (954) 340-0173

1090 Tamiami Trl
Sarasota, FL 34236
Phone 94136308782005

4700 N Habana Ave
Ste 703
Tampa, FL 33614
Phone (813) 678-2373

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1760799548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6909 SW 18TH ST.",
            "address_2": "SUITE A-203",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33433",
            "telephone_number": "561-218-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6909 SW 18TH ST.",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33433",
            "telephone_number": "561-218-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "TIMOTHY",
        "middle_name": "DJANGO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.