GEROMEDICAL PSYCHOLOGICAL SERVICE PS
NPI 1043501836
Psychologist - Clinical in Portland, OR

Q: What is Geromedical Psychological Service Ps's NPI number?

The NPI number for Geromedical Psychological Service Ps is 1043501836. It was assigned to this organization in the NPPES registry on April 27, 2011.

Q: What is Geromedical Psychological Service Ps's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since April 27, 2011

3550 SW BOND AVE, PORTLAND, OR 97239(360) 574-9565(360) 574-9685 Get Directions Write a Review

NPPES record last updated: September 17, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Geromedical Psychological Service Ps NPPES

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

GEROMEDICAL PSYCHOLOGICAL SERVICE PS (NPI 1043501836) is a healthcare organization registered as a clinical in Portland, Oregon and active in the NPI registry since April 2011. The organization lists Derick A Scovel, President, as its authorized official.

NPPES Registry Identity

NPI1043501836

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameGEROMEDICAL PSYCHOLOGICAL SERVICE PS

Location Address3550 SW BOND AVEPortland, OR 97239-4507

Mailing Address2400 Main StVancouver, WA 98660-2663 · (360) 574-9565 · Fax (360) 574-9685

Phone(360) 574-9565

Fax(360) 574-9685

Organization SubpartNo

Authorized OfficialDerick A ScovelPresident · (360) 574-9565

Enumeration DateApril 27, 2011

Last NPPES UpdateSeptember 17, 2020

NPPES CertifiedSeptember 17, 2020

✔ NPI 1043501836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in OR · 2074

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

3550 SW BOND AVE, Portland, OR 97239

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Geromedical Psychological Service Ps is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Geromedical Psychological Service Ps, which bills Medicare for the services this clinician delivers.

Clinician (1)

Derick Scovel, PHD

Clinical Psychologist

NPI 1407967813

10000 NE 7TH AVE STE 215
Vancouver, WA 98685

(360) 574-9565

✔ PECOS✔ Accepts Medicare14 mi

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

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 Geromedical Psychological Service Ps's NPI number?

The NPI number for Geromedical Psychological Service Ps is 1043501836. It was assigned to this organization in the NPPES registry on April 27, 2011.

Where is Geromedical Psychological Service Ps located?

Geromedical Psychological Service Ps is located at 3550 SW Bond Ave, Portland, OR 97239. The listed phone number is (360) 574-9565.

What is Geromedical Psychological Service Ps's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Geromedical Psychological Service Ps enrolled in Medicare?

Yes. Geromedical Psychological Service Ps is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Geromedical Psychological Service Ps?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Geromedical Psychological Service Ps. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Geromedical Psychological Service Ps was last updated on September 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.