Active NPI
Timothy Lee Sams, PHD
- Cognitive & Behavioral Psychologist
- Lake Forest, CA
National Provider Identifier
1912010885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- PSY12149
- Practice address
- 23792 Rockfield Blvd
Ste 290
Lake Forest, CA 92630 - Phone
- (949) 458-1073
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PSY12149 | CA | Primary |
Addresses
Primary practice location
23792 Rockfield Blvd
Ste 290
Lake Forest, CA 92630
Mailing address
PO Box 6599
Irvine, CA 92616
Phone (310) 608-2227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, FL, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
77564 Country Club Dr
Suite 207
Palm Desert, CA 92211-6248
Phone (760) 404-0183
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38510 | TX | MD | Pharmacist |
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 and National Provider Directory roles.
-
- Cognitive & Behavioral Psychologist
- Palm Desert, CA
- NPI 1952318586
FL, TX
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912010885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6599",
"city": "IRVINE",
"state": "CA",
"postal_code": "92616",
"telephone_number": "310-608-2227",
"fax_number": "310-632-7227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23792 ROCKFIELD BLVD",
"address_2": "STE 290",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "92630",
"telephone_number": "949-458-1073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMS",
"first_name": "TIMOTHY",
"middle_name": "LEE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "PSY12149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Forest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.