Travis Martin Shivley-scott, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Mather, California. His current practice location is
10535 Hospital Way, Mather, California. You can reach out to his office (for appointments etc.) via phone at
(916) 765-1903.
Travis Martin Shivley-scott is licensed to practice in California (license number 32064) 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 1609445444.
Healthcare Provider's Profile
| Full Name | Travis Martin Shivley-scott |
|---|
| Gender | Male |
|---|
| Speciality | Clinical Neuropsychologist |
|---|
| Location | 10535 Hospital Way, Mather, California |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1609445444
- Provider Enumeration Date: 06/24/2021
- Last Update Date: 10/07/2022
Medicare PECOS Information:
- PECOS PAC ID: 5698136836
- Enrollment ID: I20230803002188
Medical Identifiers
Medical identifiers for Travis Martin Shivley-scott such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609445444 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 32064 (California) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 32064 (California) | Primary |
| 103T00000X | Psychologist | 32064 (California) | 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. Travis Martin Shivley-scott allows following entities to bill medicare on his behalf.
| Entity Name | Brain And Behavioral Associates, Pc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1467747477
PECOS PAC ID: 2365616018
Enrollment ID: O20111116000045 |
|---|
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. Travis Martin Shivley-scott 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 |
|---|
Travis Martin Shivley-scott, PHD
418 Pepper Ct,
Vacaville, CA 95687-3324
Ph: () - | Travis Martin Shivley-scott, PHD
10535 Hospital Way,
Mather, CA 95655-4200
Ph: (916) 765-1903 |
Reviews and Comments