DR. MICHAEL ROLLOCK (PH.D.) – Clinical Psychologist, NPI 1629303870

DR. MICHAEL ROLLOCK (PH.D.) is a healthcare provider. based in Augusta, Georgia. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PSY003572 (GA). The NPI Number for DR. MICHAEL ROLLOCK (PH.D.) is 1629303870

Main info

Male
16 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL ROLLOCK (PH.D.)
NPI
1629303870
Phone
(706) 721-8623
Address
1120 15th St
Enumeration Date
6 October 2009
Last Update Date
12 April 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
Secondary Phone
7704248222
Graduation Year
2010 (16 years ago)
PAC ID
8628209632
Group Practice PAC ID
6709065402
Professional Enrollment ID
I20140314001051
Address ID
GA301527742KE5150XRDXX501
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:16State licenses:1Digital endpointsOther names

483 CLINICAL PSYCHOLOGIST in GA

Provider Addresses for DR. MICHAEL ROLLOCK (PH.D.)

  • 1120 15th St

    Augusta, GA 309123815

    Phone: (706) 721-8623

    Type: Location

  • 3405 Mike Padgett Hwy

    Augusta, GA 309063815

    Phone: (706) 792-7126

    Type: Location

  • 997 SAINT SEBASTIAN WAY

    AUGUSTA, GA 309122613

    Phone: (706) 721-6719

    Type: Location

  • 997, Saint Sebastian Way, Augusta, Richmond County, Georgia, 30901, United States

    AUGUSTA, GA 309122613

    Phone: (706) 721-6719

    Type: Mailing

  • East Central Regional Hospital, 3405, Mike Padgett Highway, Apple Valley, Augusta, Richmond County, Georgia, 30906, United States

    AUGUSTA, GA 309063815

    Phone: (706) 792-7126

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-03-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140314001051IClinical PsychologistGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
96131Evaluation of psychological test, each additional hour3412$0
90791Psychiatric diagnostic evaluation1616$0
96130Evaluation of psychological test, first hour1212$0
View full utilization report →

Insurance plans in this area (ZIP 30912)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709065402View full group profile
NameSpecialtyState
-GA
-GA
-GA
R H E U M A T O L O G YMI
Hospitalist, Internal MedicineGA
Nurse PractitionerTN
Family PracticeGA
Physician AssistantGA
Physician AssistantGA
Hospitalist, Internal MedicineGA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. MICHAEL ROLLOCK (PH.D.)?
DR. MICHAEL ROLLOCK (PH.D.) — NPI 1629303870 — is the standard way to identify this listing.
Does the file indicate DR. MICHAEL ROLLOCK (PH.D.) is practicing under active NPI?
Directory data currently reports DR. MICHAEL ROLLOCK (PH.D.) as active.
What healthcare role does DR. MICHAEL ROLLOCK (PH.D.) hold?
Scheduling teams often label DR. MICHAEL ROLLOCK (PH.D.) under Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does DR. MICHAEL ROLLOCK (PH.D.) list a practice location?
Patients near Augusta, Georgia may find DR. MICHAEL ROLLOCK (PH.D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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