DR. MICHAEL REYES MEDRANO (PHD) – Clinical Psychologist, NPI 1386382372
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
453 CLINICAL PSYCHOLOGIST in AZ
Provider Addresses for DR. MICHAEL REYES MEDRANO (PHD)
1 LINCOLN ST FL 24
BOSTON, MA 021112901
Phone: (617) 454-4672
Type: Mailing
17014 W BELL RD STE 100
SURPRISE, AZ 853742479
Phone: (623) 866-4484
Fax: (415) 252-7176
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.
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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: 2025-01-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20220713003566 | I | Clinical Psychologist | AZ | TBD |
| I20241112001618 | I | Clinical Psychologist | TX | TBD |
| I20241112002113 | I | Clinical Psychologist | CO | TBD |
| I20250110000296 | I | Clinical Psychologist | GA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90832 | Psychotherapy, 30 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 02111)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | TX | |
| Family Practice | AZ | |
| Nurse Practitioner | NH | |
| Internal Medicine, Hospice/Palliative Care | TX | |
| Nurse Practitioner | TX | |
| Cardiovascular Disease (Cardiology), Advanced Heart Failure And Transplant Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | PA | |
| Internal Medicine | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Family Practice | TX |
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