Mr Paul W Bagwell Jr, PSYD in Las Vegas, NM - Medicare Psychologist Provider

Mr Paul W Bagwell Jr, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Las Vegas, New Mexico. His current practice location is 3695 Hot Springs Blvd, Las Vegas, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 454-2100.

Mr Paul W Bagwell Jr is licensed to practice in New Mexico (license number 0854) 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 1477608453.

Contact Information

	Mr Paul W Bagwell Jr, PSYD
	3695 Hot Springs Blvd, Las Vegas, NM 87701-9549
	(505) 454-2100
	(505) 454-2130

Healthcare Provider's Profile

Full Name	Mr Paul W Bagwell Jr
Gender	Male
Speciality	Psychologist - Clinical
Location	3695 Hot Springs Blvd, Las Vegas, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1477608453
Provider Enumeration Date: 01/23/2007
Last Update Date: 07/22/2010

Medicare PECOS Information:

PECOS PAC ID: 4183808983
Enrollment ID: I20110401000450

Medical Identifiers

Medical identifiers for Mr Paul W Bagwell Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477608453	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	0854 (New Mexico)	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. Mr Paul W Bagwell Jr allows following entities to bill medicare on his behalf.

Entity Name	State Of New Mexico
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1992867998 PECOS PAC ID: 2062412869 Enrollment ID: O20091021000191

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Medicare Part D Prescriber Enrollment

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Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Paul W Bagwell Jr, PSYD 3695 Hot Springs Blvd, Las Vegas, NM 87701-9549 Ph: (505) 454-2100	Mr Paul W Bagwell Jr, PSYD 3695 Hot Springs Blvd, Las Vegas, NM 87701-9549 Ph: (505) 454-2100

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Psychologist in Las Vegas, NM

Wendy Price, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3695 Hot Springs Blvd, Las Vegas, NM 87701 Phone: 505-454-2100
William Frank Merkle, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3695 Hot Springs Blvd, Las Vegas, NM 87701 Phone: 505-454-2457
Ms. Michelle Ulibarri, PSY Psychologist Medicare: Not Enrolled in Medicare Practice Location: 179 Bridge St, Las Vegas, NM 87701 Phone: 505-426-2554
Dr. Diana Calderon, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1801 Seventh Street, Las Vegas, NM 87701 Phone: 505-454-9758 Fax: 505-454-9755
Rudy Fidencio Grano, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 213 Plaza St, N/a, Las Vegas, NM 87701 Phone: 505-617-6313 Fax: 505-617-6313
Dr. Linda T Kennedy, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 509 11th St, Suite A, Las Vegas, NM 87701 Phone: 505-425-3155 Fax: 505-425-3155
Theresa Carvell, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3695 Hot Springs Blvd, Las Vegas, NM 87701 Phone: 505-454-2100

Mr Paul W Bagwell Jr, PSYD - Medicare Psychologist in Las Vegas, NM

Contact Information

Healthcare Provider's Profile

Medical Identifiers

Medical Taxonomies and Licenses

Medicare Reassignments

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Medicare Part D Prescriber Enrollment

Mailing Address and Practice Location

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Psychologist in Las Vegas, NM