Scott A Bandoroff, PSYCHOLOGIST (PHD)

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

OR1120 Issued in OR

Practice address

149 Clear Creek Dr
Suite 110
Ashland, OR 97520

Phone

(541) 951-4329

Fax

(503) 419-4662

NPI assigned

Jul 23, 2007

Last updated

Apr 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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.

• Peak Experience, PC

  • Community/Behavioral Health Agency
  • Ashland, OR
  • NPI 1154794832
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1801096334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 503010",
            "address_2": "X",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975030813",
            "telephone_number": "541-941-7792",
            "fax_number": "503-419-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 CLEAR CREEK DR",
            "address_2": "SUITE 110",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "97520",
            "telephone_number": "541-951-4329",
            "fax_number": "503-419-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDOROFF",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST (PHD)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OR",
            "license": "1120",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OR",
            "license": "OR1120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Bakner, LAC
• Melodee Baldridge, LPC
• Jaime Marie Ball, DPT
• Lucille Jean Ball, LMFT WITH A PH.D.
• Molly Ballew
• Angela Barber, SLP
• Malinda Barclay, LCSW
• Barika LLC
• Lucy Larkin Barnes, DOULA
• Heather L. Barraclough, FNP-C

• Clinical Child & Adolescent Psychologist in Ashland, OR
• Providers in Ashland, OR by specialty
• Clinical Child & Adolescent Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; 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.