MS. BLAKELY ELIZABETH MULDER MA, AGS
NPI 1629698683
Psychologist - School in Durham, NC

NPI Status: Active since April 20, 2020

Contact Information

5842 FAYETTEVILLE RD STE 106
DURHAM, NC
ZIP 27713
Phone: (919) 572-0000

NPI Profile Information
Primary Taxonomy
Medicare Participation & PECOS Status
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Psychologist
School
Opted-Out Medicare

About BLAKELY MULDER

This page provides the complete NPI Profile along with additional information for Blakely Mulder, a provider established in Durham, North Carolina with a medical specialization in Psychologist, focusing in school . The healthcare provider is registered in the NPI registry with number 1629698683 assigned on April 2020. The practitioner's primary taxonomy code is 103TS0200X with license number 1236076 (NC). The provider is registered as an individual and her NPI record was last updated 6 years ago.

NPI: 1629698683
Provider Name: MS. BLAKELY ELIZABETH MULDER MA, AGS
Gender: Female
Entity Type: Individual
Location Address: 5842 FAYETTEVILLE RD STE 106 DURHAM, NC 27713
Location Phone: (919) 572-0000
Mailing Address: 5842 FAYETTEVILLE RD STE 106 DURHAM, NC 27713
Mailing Phone: (919) 572-0000
Is Sole Proprietor?: No
Enumeration Date: 04-20-2020
Last Update Date: 04-20-2020
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The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Blakely Mulder opted out of Medicare effective on 11-03-2021 until 11-03-2025. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Psychologist School
Taxonomy Code: 103TS0200X
Type: Behavioral Health & Social Service Providers
License No.: 1236076
License State: NC
Taxonomy Description: A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a range of psychological diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families and other systems. School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. In these efforts, they conduct ecologically valid assessments and intervene to promote positive learning environments within which children and youth from diverse backgrounds to ensure that all have equal access to effective educational and psychological services that promote healthy development

Medicare Participation & PECOS Enrollment Status

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Opted-Out of Medicare? Yes
Opt-Out Effective Date: 11-03-2021
Opt-Out End Date: 11-03-2025
Eligible to Order and Refer? No

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1629698683, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 77. The final step is to find the difference between that total and the next multiple of ten (80 - 77 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 4

Pos 4

Unchanged

Pos 5

Doubled → 12 → 1 + 2

Pos 6

Unchanged

Pos 7

Doubled → 16 → 1 + 6

Pos 8

Unchanged

Pos 9

Doubled → 16 → 1 + 6

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 6 → 12 → 3 8 → 16 → 7 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 4 + 9 + 1 + 2 + 9 + 1 + 6 + 6 + 1 + 6 + 24 = 77

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 77 is 80. The difference is the calculated check digit.

80 - 77 = 3

This NPI is valid

The calculated check digit is 3, which matches the last digit of 1629698683.