Peter Durham, PSYD is a medicare enrolled "Clinical Neuropsychologist" provider in Round Rock, Texas. His current practice location is
425 University Blvd, Round Rock, Texas. You can reach out to his office (for appointments etc.) via phone at
(512) 509-0200.
Peter Durham is licensed to practice in Texas (license number 39921) 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 1962196188.
Healthcare Provider's Profile
| Full Name | Peter Durham |
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| Gender | Male |
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| Speciality | Clinical Neuropsychologist |
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| Location | 425 University Blvd, Round Rock, 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: 1962196188
- Provider Enumeration Date: 06/08/2023
- Last Update Date: 12/28/2023
Medicare PECOS Information:
- PECOS PAC ID: 6406202225
- Enrollment ID: I20231030002567
Medical Identifiers
Medical identifiers for Peter Durham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962196188 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 39921 (Texas) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 39921 (Texas) | 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. Peter Durham allows following entities to bill medicare on his behalf.
| Entity Name | Scott & White Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093779704
PECOS PAC ID: 8123923604
Enrollment ID: O20031223000640 |
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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. Peter Durham 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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Peter Durham, PSYD
Po Box 844658,
Dallas, TX 75284-4658
Ph: (800) 994-0371 | Peter Durham, PSYD
425 University Blvd,
Round Rock, TX 78665-1047
Ph: (512) 509-0200 |
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