1. Home
  2. Directory
  3. Florida
  4. Bradenton
  5. Counselor
  6. NPI Profile

DR. THOMAS WILLIAM CLYBURN III PH.D.
NPI 1285879361
Counselor - Mental Health in Bradenton, FL

Active since December 03, 2008PECOS EnrolledAccepts Medicare Assignment
318 OLD MAIN ST, SUITE 21, BRADENTON, FL 34205(941) 224-3800(941) 745-1630 Get Directions Write a Review

NPPES record last updated: April 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Thomas William Clyburn Iii Ph.d. NPPES

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

DR. THOMAS WILLIAM CLYBURN III PH.D. (NPI 1285879361) is an individual mental health provider in Bradenton, Florida, licensed in Florida (MH7314) and active in the NPI registry since December 2008. He is enrolled in Medicare PECOS, maintains a secondary practice location in Sarasota, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1285879361
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameDR. THOMAS WILLIAM CLYBURN IIICredential: PH.D.
Location Address318 OLD MAIN ST, SUITE 21Bradenton, FL 34205-7819
Mailing Address4501 Manatee Ave W # 209Bradenton, FL 34209-3952 · (941) 224-3800 · Fax (941) 745-1630
Phone(941) 224-3800
Fax(941) 745-1630
Sole ProprietorYes
Medical School CMSOtherGraduated 2001
Enumeration DateDecember 3, 2008
Last NPPES UpdateApril 20, 2026
NPPES CertifiedApril 20, 2026
✔ NPI 1285879361 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in FL · MH7314
318 OLD MAIN ST, Bradenton, FL 34205
Open in Google Maps ↗

Secondary Practice Location 1

Location 12033 Wood St Ste 220Sarasota, FL 34237-7927 · Phone (941) 677-3366 · Fax (941) 677-3367

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and more.Insurance ›

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. Thomas William Clyburn Iii Ph.d. 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 ID9537600101
PECOS Enrollment IDI20240923002708
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 Thomas Clyburn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Center Of Revitalizing Psychiatry, P.C.
1,044 mi
Psychiatry
340 W PASSAIC ST STE 1
Rochelle Park, NJ 07662
  • Reassigned Medicare billing, Florida enrollment
  • 27 clinicians in this Medicare group
NPI 1356497960 (201) 488-5161

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 Thomas Clyburn's NPI number?

The NPI number for Thomas Clyburn is 1285879361. It was assigned to this individual provider in the NPPES registry on December 3, 2008.

Where is Thomas Clyburn located?

Thomas Clyburn practices at 318 Old Main St Suite 21, Bradenton, FL 34205. The listed phone number is (941) 224-3800.

What is Thomas Clyburn's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Thomas Clyburn enrolled in Medicare?

Yes. Thomas Clyburn 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 Thomas Clyburn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Clyburn reassigns Medicare benefits to Center Of Revitalizing Psychiatry, P.C. (Rochelle Park, NJ). 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 Thomas Clyburn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thomas Clyburn accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare, Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Thomas Clyburn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thomas Clyburn was last updated on April 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.