Dr Peter L Stavinoha, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Houston, Texas. His current practice location is
1515 Holcombe Blvd, Houston, Texas. You can reach out to his office (for appointments etc.) via phone at
(713) 792-6161.
Dr Peter L Stavinoha is licensed to practice in Texas (license number 25476) 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 1255499356.
Healthcare Provider's Profile
| Full Name | Dr Peter L Stavinoha |
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| Gender | Male |
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| Speciality | Clinical Neuropsychologist |
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| Location | 1515 Holcombe Blvd, Houston, Texas |
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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: 1255499356
- Provider Enumeration Date: 12/04/2006
- Last Update Date: 08/18/2020
Medicare PECOS Information:
- PECOS PAC ID: 9931416104
- Enrollment ID: I20150921001684
Medical Identifiers
Medical identifiers for Dr Peter L Stavinoha such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1255499356 | NPI | - | NPPES |
| 039133606 | Medicaid | TX | |
| 039133607 | Other | TX | CSHCN TPI |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 25476 (Texas) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 25476 (Texas) | Secondary |
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | 25476 (Texas) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 25476 (Texas) | Primary |
| 103TR0400X | Psychologist - Rehabilitation | 25476 (Texas) | Secondary |
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 Peter L Stavinoha allows following entities to bill medicare on his behalf.
| Entity Name | Physicians Referral Service |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073574810
PECOS PAC ID: 7911801410
Enrollment ID: O20031125000953 |
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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 Peter L Stavinoha 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 Peter L Stavinoha, PHD
Po Box 4439,
Houston, TX 77210-4439
Ph: (713) 792-2991 | Dr Peter L Stavinoha, PHD
1515 Holcombe Blvd,
Houston, TX 77030-4000
Ph: (713) 792-6161 |
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