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DR. DYLAN VAUGHN PHD
NPI 1023875960
Clinical Neuropsychologist in Los Angeles, CA

Active since March 05, 2024PECOS EnrolledAccepts Medicare Assignment
11835 W OLYMPIC BLVD STE 1270E, LOS ANGELES, CA 90064(310) 620-2185 Get Directions Write a Review

NPPES record last updated: April 29, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 29, 2024, Mar 5, 2024 (2 updates tracked since 2024).

About Dr. Dylan Vaughn Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DYLAN VAUGHN PHD (NPI 1023875960) is an individual clinical neuropsychologist in Los Angeles, California, licensed in California (34877) and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1023875960
Entity TypeIndividualMale
Primary Taxonomy103G00000X
Provider Legal NameDR. DYLAN VAUGHNCredential: PHD
Location Address11835 W OLYMPIC BLVD STE 1270ELos Angeles, CA 90064-5053
Mailing Address11835 W Olympic Blvd Ste 1270eLos Angeles, CA 90064-5053
Phone(310) 620-2185
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMarch 5, 2024
Last NPPES UpdateApril 29, 20242 updates tracked since enumeration
NPPES CertifiedApril 29, 2024
✔ NPI 1023875960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in CA · 34877
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
11835 W OLYMPIC BLVD STE 1270E, Los Angeles, CA 90064
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Dylan Vaughn Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3375980733
PECOS Enrollment IDI20240320003042
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Dylan Vaughn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Executive Mental Health, Inc.
Same address
Mental Health
11835 W OLYMPIC BLVD STE 1270E
Los Angeles, CA 90064
  • Reassigned Medicare billing, California enrollment
  • 53 clinicians in this Medicare group
NPI 1275670036 (310) 273-4843

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Evaluation of neuropsychological test, each additional hour 96133
This service involves further evaluation of your neuropsychological test results beyond the initial hour. It helps to understand your cognitive functioning better, focusing on areas like memory, attention, and problem-solving skills.
902 services300 patients
Exam of neurobehavioral status, each additional hour 96121
This procedure involves a thorough evaluation of your neurobehavioral status, focusing on brain functions that affect behavior and cognition. It's extended for an additional hour to gather more detailed information about your neurological health.
572 services308 patients
Exam of neurobehavioral status, first hour 96116
An exam of neurobehavioral status is a medical procedure that evaluates your brain's functions. This includes assessing your cognitive abilities, emotional responses, and behavioral patterns. The first hour of the exam is typically dedicated to this initial evaluation.
321 services315 patients
Administration of psychological or neuropsychological test, first 30 minutes 96136
This procedure involves a health professional conducting a psychological or neuropsychological test. The first 30 minutes typically involve understanding your mental health or brain function through various assessments. This helps in diagnosing and treating mental health disorders effectively.
307 services301 patients
Administration of psychological or neuropsychological test, each additional 30 minutes 96137
This procedure involves administering psychological or neuropsychological tests to evaluate your mental functions. Each additional 30 minutes allows for a more in-depth assessment of your cognitive abilities, emotions, and behavior. It's crucial for accurate diagnosis and treatment planning.
306 services300 patients
Evaluation of neuropsychological test, first hour 96132
An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.
305 services299 patients

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CONRAD DANIEL SPEZZACATENA PSY.D.
Clinical Neuropsychologist
11835 W OLYMPIC BLVD STE 1270E
LOS ANGELES, CA 90064
Los Angeles County (623) 377-7410
EXECUTIVE MENTAL HEALTH, INC.
Counselor (Mental Health)
11835 W OLYMPIC BLVD STE 1270E
LOS ANGELES, CA 90064
Los Angeles County (310) 273-4843
HOLLY GEORGE
Clinical Neuropsychologist
11835 W OLYMPIC BLVD STE 1270E
LOS ANGELES, CA 90064
Los Angeles County (310) 273-4843
JUNG YUN JANG PH.D.
Psychologist
11835 W OLYMPIC BLVD STE 1270E
LOS ANGELES, CA 90064
Los Angeles County (310) 273-4843
DR. AMANDA TING PH.D.
Psychologist (Clinical)
11835 W OLYMPIC BLVD STE 1270E
LOS ANGELES, CA 90064
Los Angeles County (310) 273-4843
MARAL AGHVINIAN
Clinical Neuropsychologist
11835 W OLYMPIC BLVD STE 1270E
LOS ANGELES, CA 90064
Los Angeles County (310) 273-4843
NESHA HARPER PHD
Psychologist
11835 W OLYMPIC BLVD STE 1270E
LOS ANGELES, CA 90064
Los Angeles County (310) 273-4843
COURTNEY CRISP
Psychologist
11835 W OLYMPIC BLVD STE 1270E
LOS ANGELES, CA 90064
Los Angeles County (310) 273-4843

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dylan Vaughn's NPI number?

The NPI number for Dylan Vaughn is 1023875960. It was assigned to this individual provider in the NPPES registry on March 5, 2024.

Where is Dylan Vaughn located?

Dylan Vaughn practices at 11835 W Olympic Blvd Ste 1270E, Los Angeles, CA 90064. The listed phone number is (310) 620-2185.

What is Dylan Vaughn's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Dylan Vaughn enrolled in Medicare?

Yes. Dylan Vaughn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Dylan Vaughn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dylan Vaughn reassigns Medicare benefits to Executive Mental Health, Inc. (Los Angeles, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dylan Vaughn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Dylan Vaughn was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.