THE UNDISCOVERED SELF, PC
NPI 1487514212
Psychologist in Boise, ID
About The Undiscovered Self, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THE UNDISCOVERED SELF, PC (NPI 1487514212) is a healthcare organization registered as a psychologist in Boise, Idaho and active in the NPI registry since November 2025. The organization lists John Anthony Beradino, Psychologist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
The Undiscovered Self, Pc 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 The Undiscovered Self, PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 The Undiscovered Self, PC's NPI number?
The NPI number for The Undiscovered Self, PC is 1487514212. It was assigned to this organization in the NPPES registry on November 14, 2025.
Where is The Undiscovered Self, PC located?
The Undiscovered Self, PC is located at 1015 W Hays St Ste 205, Boise, ID 83702. The listed phone number is (310) 500-6862.
What is The Undiscovered Self, PC's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is The Undiscovered Self, PC enrolled in Medicare?
Yes. The Undiscovered Self, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through The Undiscovered Self, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to The Undiscovered Self, PC. 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.
What insurance does The Undiscovered Self, PC accept?
Health plans from Moda Health Plan, Inc. list The Undiscovered Self, PC 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 The Undiscovered Self, PC was last updated on November 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.