Carissa D Bravo, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Medford, Oregon. She graduated from healthcare school in 2017 and has 9 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice Providence Health And Services Oregon and her current practice location is
70 Bower Dr, Medford, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 734-3430.
Carissa D Bravo is licensed to practice in Oregon (license number 3008) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1538562749.
Healthcare Provider's Profile
| Full Name | Carissa D Bravo |
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| Gender | Female |
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| Speciality | Clinical Psychologist |
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| Experience | 9 Years |
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| Location | 70 Bower Dr, Medford, Oregon |
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| Accepts Medicare Assignments | Yes. She 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:
- Carissa D Bravo graduated from medical school in 2017
NPI Data:
- NPI Number: 1538562749
- Provider Enumeration Date: 10/01/2014
- Last Update Date: 04/09/2020
Medicare PECOS Information:
- PECOS PAC ID: 6406194141
- Enrollment ID: I20190205002211
Medical Identifiers
Medical identifiers for Carissa D Bravo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538562749 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 3008 (Oregon) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Providence Health And Services Oregon | 5294623245 | 158 |
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. Carissa D Bravo allows following entities to bill medicare on her behalf.
| Entity Name | Providence Health & Services Oregon |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568547503
PECOS PAC ID: 5294623245
Enrollment ID: O20040310000315 |
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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. Carissa D Bravo 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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Carissa D Bravo, PSYD
Po Box 3158,
Portland, OR 97208-3158
Ph: (541) 734-3430 | Carissa D Bravo, PSYD
70 Bower Dr,
Medford, OR 97501-3689
Ph: (541) 734-3430 |
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