Dr Paul A Davis, PHD, LP is a medicare enrolled "Psychologist - Clinical" provider in Staples, Minnesota. He graduated from medical school in 2000 and has 24 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Lakewood Health System and his current practice location is
49725 County 83, Staples, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(218) 894-1515.
Dr Paul A Davis is licensed to practice in Minnesota (license number LP5313) 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 1619995297.
Healthcare Provider's Profile
| Full Name | Dr Paul A Davis |
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| Gender | Male |
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| Speciality | Clinical Psychologist |
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| Experience | 24 Years |
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| Location | 49725 County 83, Staples, Minnesota |
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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:
- Dr Paul A Davis graduated from medical school in 2000
NPI Data:
- NPI Number: 1619995297
- Provider Enumeration Date: 07/18/2006
- Last Update Date: 02/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 3577462555
- Enrollment ID: I20110209000991
Medical Identifiers
Medical identifiers for Dr Paul A Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619995297 | NPI | - | NPPES |
| 78G33DA | Other | MN | BLUE CROSS/SHIELD MINNESO |
| 26928 | Other | ND | BLUE CROSS/SHIELD NO DAK |
| 475441030848 | Other | | PREFERREDONE |
| HP35347 | Other | | HEALTHPARTNERS |
| 11891 | Medicaid | ND | |
| 445092200 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 355 (North Dakota) | Secondary |
| 103TC0700X | Psychologist - Clinical | LP5313 (Minnesota) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Lakewood Health System | 1052229671 | 78 |
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 Paul A Davis allows following entities to bill medicare on his behalf.
| Entity Name | Lakewood Health System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1841280823
PECOS PAC ID: 1052229671
Enrollment ID: O20031104000411 |
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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 Paul A Davis 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 Paul A Davis, PHD, LP
49725 County 83,
Staples, MN 56479-5280
Ph: (218) 894-1515 | Dr Paul A Davis, PHD, LP
49725 County 83,
Staples, MN 56479-5280
Ph: (218) 894-1515 |
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