Brent D Fisk, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Newberg, Oregon. He graduated from healthcare school in 2018 and has 7 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Salem Health and his current practice location is
1003 Providence Dr Ste 110, Newberg, Oregon. You can reach out to his office (for appointments etc.) via phone at
(503) 537-5900.
Brent D Fisk is licensed to practice in Oregon (license number 3093) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1124418561.
Healthcare Provider's Profile
| Full Name | Brent D Fisk |
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| Gender | Male |
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| Speciality | Clinical Psychologist |
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| Experience | 7 Years |
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| Location | 1003 Providence Dr Ste 110, Newberg, Oregon |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Brent D Fisk graduated from medical school in 2018
NPI Data:
- NPI Number: 1124418561
- Provider Enumeration Date: 01/23/2015
- Last Update Date: 10/06/2020
Medicare PECOS Information:
- PECOS PAC ID: 3779916887
- Enrollment ID: I20191204000372
Medical Identifiers
Medical identifiers for Brent D Fisk such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1124418561 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 3093 (Oregon) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Salem Health | 8628986668 | 435 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brent D Fisk allows following entities to bill medicare on his behalf.
| Entity Name | Salem Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1265431829
PECOS PAC ID: 8628986668
Enrollment ID: O20040309001131 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brent D Fisk is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Brent D Fisk, PSYD
Po Box 3158,
Portland, OR 97208-3158
Ph: (503) 215-6494 | Brent D Fisk, PSYD
1003 Providence Dr Ste 110,
Newberg, OR 97132-7521
Ph: (503) 537-5900 |
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