Dr Evan Lockary, PSYD is a medicare enrolled "Psychologist - Clinical Child & Adolescent" provider in Portland, Oregon. His current practice location is
11010 Se Division St Ste 202, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at
(503) 335-5975.
Dr Evan Lockary is licensed to practice in Oregon (license number 3416) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1457787939.
Healthcare Provider's Profile
| Full Name | Dr Evan Lockary |
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| Gender | Male |
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| Speciality | Psychologist - Clinical Child & Adolescent |
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| Location | 11010 Se Division St Ste 202, 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: 1457787939
- Provider Enumeration Date: 09/17/2013
- Last Update Date: 07/03/2021
Medicare PECOS Information:
- PECOS PAC ID: 5799189361
- Enrollment ID: I20210803003895
Medical Identifiers
Medical identifiers for Dr Evan Lockary such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457787939 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 3416 (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 Evan Lockary allows following entities to bill medicare on his behalf.
| Entity Name | Options Counseling Services Of Oregon |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1548275217
PECOS PAC ID: 1658674197
Enrollment ID: O20160215000168 |
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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 Evan Lockary 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 |
|---|
Dr Evan Lockary, PSYD
1630 Se Rural St Apt 202,
Portland, OR 97202-5861
Ph: (415) 847-0838 | Dr Evan Lockary, PSYD
11010 Se Division St Ste 202,
Portland, OR 97266-6400
Ph: (503) 335-5975 |
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