Dr Sean Dodge, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Redmond, Oregon. His current practice location is
211 Nw Larch Ave, Redmond, Oregon. You can reach out to his office (for appointments etc.) via phone at
(541) 548-2164.
Dr Sean Dodge is licensed to practice in Oregon (license number 2871) 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 1922256809.
Healthcare Provider's Profile
| Full Name | Dr Sean Dodge |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 211 Nw Larch Ave, Redmond, Oregon |
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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: 1922256809
- Provider Enumeration Date: 09/03/2008
- Last Update Date: 04/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 2668641523
- Enrollment ID: I20110810000127
Medical Identifiers
Medical identifiers for Dr Sean Dodge such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1922256809 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | PY0624 (Nevada) | Secondary |
| 103TC0700X | Psychologist - Clinical | 2871 (Oregon) | 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. Dr Sean Dodge allows following entities to bill medicare on his behalf.
| Entity Name | State Of Nevada |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760572010
PECOS PAC ID: 9234022153
Enrollment ID: O20040212000160 |
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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 Sean Dodge 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 Sean Dodge, PSYD
1900 Ne 3rd St Ste 1061019,
Bend, OR 97701-3894
Ph: (775) 297-8855 | Dr Sean Dodge, PSYD
211 Nw Larch Ave,
Redmond, OR 97756-1357
Ph: (541) 548-2164 |
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