NPIMap

Individual provider Active NPI

Michael Gerard Selders, PH.D.

  • Psychologist
  • Dallas, TX
National Provider Identifier
1851531925
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
34549 Issued in TX
Practice address
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone
(214) 590-8761
Fax
(214) 590-1491
NPI assigned
Mar 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 34549 TX
Clinical Psychologist 103TC0700X 071007630 IL
Psychologist 103T00000X 34549 TX Primary

Addresses

Primary practice location

5200 Harry Hines Blvd
Dallas, TX 75235-7709

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624

Other practice location 1

2602 Martin Luther King Jr Blvd
Dallas, TX 75215-2309
Phone (214) 421-0821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130605000008 TX Practitioner - Clinical Psychologist 4486892353 Reassigns benefits to 2 organizations
Practice locations: Lancaster, TX; Desoto, TX; Dallas, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

5151 Maple Ave
Dallas, TX 75235-8136
Phone (214) 266-3333

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8000

5201 Harry Hines Blvd
Dallas, TX 75235-7708
Phone (214) 590-5582

5201 Harry Hines VLVD
Dallas, TX 75235-7708
Phone (214) 590-5582

5323 Harry Hines Blvd
Dallas, TX 75390-9257

Hospital & facility affiliations

  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071007630ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2017 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2017 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Center for Psychological Services, PLLC CurrentSince Mar 6, 2013 Accepting new patients
Center for Psychological Services, PLLC Psychologist CurrentSince Mar 6, 2013 Accepting new patients
Victorian Healthcare Past Accepting new patients

Locations

6043 W Interstate 20
Arlington, TX 76017
Phone (817) 533-0825

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

3333 Lee Pkwy
Ste 600
Dallas, TX 75219
Phone (817) 533-0825

1307 8th Ave
Ste 310
Ft Worth, TX 76104
Phone (817) 533-0825

1208 Fall Creek Hwy
Ste E
Granbury, TX 76049
Phone (817) 533-0818

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 6

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.

Hospital & facility affiliations 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851531925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357709",
            "telephone_number": "214-590-8761",
            "fax_number": "214-590-1491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2602 Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752152309",
            "country_code": "US",
            "telephone_number": "214-421-0821",
            "fax_number": "214-421-0813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELDERS",
        "first_name": "MICHAEL",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34549",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007630",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "34549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.