HEIDI L MUSGRAVE (PH.D) – Clinical Psychologist, NPI 1639161532
Clinical Psychologist
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for HEIDI L MUSGRAVE (PH.D)
700 Broadway
Fort Wayne, IN 468021402
Phone: (260) 409-2099
Type: Location
1720 Beacon St
Fort Wayne, IN 468054749
Phone: (260) 373-8000
Fax: (260) 373-8034
Type: Location
6334, Constitution Drive, Covington Dells, Fort Wayne, Allen County, Indiana, 46804, United States
FORT WAYNE, IN 46804
Phone: (260) 409-2099
Type: Mailing
2250 LAKE AVE STE 110
FORT WAYNE, IN 468055352
Phone: (260) 409-2099
Fax: (260) 436-2135
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: 2004-09-02
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040902000892 | I | Clinical Psychologist | IN | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46802)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHOLOGIST, CLINICAL | IN | 96118 | Neuropsychological testing, interpretation, and report by psychologist or physician per hour | 135 | 56 |
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