Roger Grayson Hodge, PSYD LCP is a medicare enrolled "Psychologist" provider in San Diego, California. His current practice location is
4025 Camino Del Rio S Ste 250, San Diego, California. You can reach out to his office (for appointments etc.) via phone at
(619) 858-3105.
Roger Grayson Hodge is licensed to practice in California (license number 26148) 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 1306096714.
Healthcare Provider's Profile
| Full Name | Roger Grayson Hodge |
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| Gender | Male |
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| Speciality | Psychologist |
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| Location | 4025 Camino Del Rio S Ste 250, San Diego, California |
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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: 1306096714
- Provider Enumeration Date: 09/22/2008
- Last Update Date: 12/06/2023
Medicare PECOS Information:
- PECOS PAC ID: 0244585594
- Enrollment ID: I20180611000834
Medical Identifiers
Medical identifiers for Roger Grayson Hodge such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1306096714 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 106H00000X | Marriage & Family Therapist | MFC44634 (California) | Secondary |
| 103T00000X | Psychologist | 26148 (California) | 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. Roger Grayson Hodge allows following entities to bill medicare on his behalf.
| Entity Name | Centro De Salud De La Comunidad De San Ysidro, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124782685
PECOS PAC ID: 6901709435
Enrollment ID: O20040130000711 |
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| Entity Name | Operation Samahan Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275617169
PECOS PAC ID: 7911932645
Enrollment ID: O20051001000054 |
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| Entity Name | Center For Enriching Relationships, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457591364
PECOS PAC ID: 0143506667
Enrollment ID: O20170418002354 |
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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. Roger Grayson Hodge 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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Roger Grayson Hodge, PSYD LCP
Po Box 2207,
El Cajon, CA 92021
Ph: (760) 500-1781 | Roger Grayson Hodge, PSYD LCP
4025 Camino Del Rio S Ste 250,
San Diego, CA 92108-4100
Ph: (619) 858-3105 |
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