Individual provider Active NPI

Stacy Ogbeide, PSYD

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1770987240
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
36820 Issued in TX
Practice address
903 W Martin St
Family Health Center-Downtown
San Antonio, TX 78207-0903
Phone
(210) 358-3985
NPI assigned
Oct 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 36820 TX Primary

Addresses

Primary practice location

903 W Martin St
Family Health Center-Downtown
San Antonio, TX 78207-0903

Mailing address

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (221) 035-8398

Other identifiers 2

IdentifierTypeStateIssuer
348494101MedicaidTX
348494102OtherTXCSHCN

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
I20150225000620 TX Practitioner - Clinical Psychologist 5496071177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 450-9000

903 W Martin St
San Antonio, TX 78207-0903
Phone (210) 358-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36820TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Sep 21, 2015 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Sep 21, 2015 Accepting new patients

Locations

903 W Martin St
San Antonio, TX 78207
Phone (210) 358-3400

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

Organizations & group practices 3

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": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1770987240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "221-035-8398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST",
            "address_2": "FAMILY HEALTH CENTER-DOWNTOWN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782070903",
            "telephone_number": "210-358-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBEIDE",
        "first_name": "STACY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348494101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "348494102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.