Active NPI
Darius Dexter Campinha-Bacote, PSY.D.
- Psychologist
- Fort Worth, TX
National Provider Identifier
1992199384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 36915
- Practice address
- 5601 Bridge St
Ste 300
Fort Worth, TX 76112-2384 - Phone
- (214) 945-4295
- Fax
- (817) 492-7001
- NPI assigned
- Mar 24, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 36915 | TX | Primary |
Addresses
Primary practice location
5601 Bridge St
Ste 300
Fort Worth, TX 76112-2384
Mailing address
5601 Bridge St
Ste 300
Fort Worth, TX 76112-2355
Phone (214) 945-4295
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150724010891 | TX | Practitioner - Clinical Psychologist | 5496073017 | Practice locations: Fort Worth, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36915 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472083200000",
"number": "1992199384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5601 BRIDGE ST",
"address_2": "STE 300",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761122355",
"telephone_number": "214-945-4295",
"fax_number": "817-492-7001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 BRIDGE ST",
"address_2": "STE 300",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761122384",
"telephone_number": "214-945-4295",
"fax_number": "817-492-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPINHA-BACOTE",
"first_name": "DARIUS",
"middle_name": "DEXTER",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-03-24",
"last_updated": "2016-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "36915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.