Camille Gonzalez Mami, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

36482 Issued in TX

Practice address

11211 Taylor Draper LN
Suite 202
Austin, TX 78759-3916

Phone

(512) 343-8850

Fax

(512) 343-8079

NPI assigned

Dec 26, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Camille Cassandra Gonzalez Former name

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

Merit-based Incentive Payment System (MIPS)

Final score

88.89 of 100Reported as group

Quality

80

Improvement activities

40

Cost

72.96

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Behavioral Health Consultants

  • Psychologist
  • Austin, TX
  • NPI 1245275155
  Medicare reassignment

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1922429505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 TAYLOR DRAPER LN",
            "address_2": "SUITE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787593916",
            "telephone_number": "512-343-8850",
            "fax_number": "512-343-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 TAYLOR DRAPER LN",
            "address_2": "SUITE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787593916",
            "telephone_number": "512-343-8850",
            "fax_number": "512-343-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMI",
        "first_name": "CAMILLE",
        "middle_name": "GONZALEZ",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-26",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "36482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILLE",
            "last_name": "GONZALEZ",
            "middle_name": "CASSANDRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sofia Malvaez
• Neha Mambapoor, M.ED, LPC
• Viswajyothi Mambapoor, MD
• Adam Joseph Mamelak, M.D.
• Nicholas George Mamey
• Shanya Manadier
• Munsa Manandhar
• Daniel Manas, PT, DPT, OCS, CSCS
• Poonam Mehta Manasa, M.D.
• Jason Mance, PHARMD

• Psychologist in Austin, TX
• Providers in Austin, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; 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.