Dr Amanda D Ball, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Portland, Oregon. Her current practice location is
3181 Sw Sam Jackson Park Rd, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at
(503) 494-6176.
Dr Amanda D Ball is licensed to practice in Oregon (license number 2685) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003116112.
Healthcare Provider's Profile
| Full Name | Dr Amanda D Ball |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 3181 Sw Sam Jackson Park Rd, Portland, Oregon |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1003116112
- Provider Enumeration Date: 10/25/2010
- Last Update Date: 01/11/2023
Medicare PECOS Information:
- PECOS PAC ID: 7618112137
- Enrollment ID: I20191122001593
Medical Identifiers
Medical identifiers for Dr Amanda D Ball such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003116112 | 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 | 071008473 (Illinois) | Secondary |
| 103TC0700X | Psychologist - Clinical | 2685 (Oregon) | Primary |
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. Dr Amanda D Ball allows following entities to bill medicare on her behalf.
| Entity Name | Kaiser Foundation Health Plan Of The Northwest |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1184786527
PECOS PAC ID: 5799688230
Enrollment ID: O20040130000799 |
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| Entity Name | University Professional Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376709535
PECOS PAC ID: 4880760107
Enrollment ID: O20080910000013 |
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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. Dr Amanda D Ball 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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Dr Amanda D Ball, PSYD
1400 Sw 5th Ave Ste 500,
Portland, OR 97201-5537
Ph: (866) 617-6855 | Dr Amanda D Ball, PSYD
3181 Sw Sam Jackson Park Rd,
Portland, OR 97239-3011
Ph: (503) 494-6176 |
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