MICHAEL PAUL DOERFLEIN LCSW
NPI 1720223571
Social Worker in Houston, TX
NPI Status: Active since December 09, 2008
Contact Information
2015 THOMAS ST.
HOUSTON, TX
ZIP 77009
Phone: (713) 873-4029
Fax: (832) 203-5115
- Individual
- Male
- Years of Experience 27
- Social Worker
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MICHAEL DOERFLEIN
This page provides the complete NPI Profile along with additional information for Michael Doerflein, a provider established in Houston, Texas with a medical specialization in Social Worker and more than 27 years of experience. The healthcare provider is registered in the NPI registry with number 1720223571 assigned on December 2008. The practitioner's primary taxonomy code is 104100000X with license number 30466 (TX). The provider is registered as an individual and his NPI record was last updated 17 years ago.
- NPI
- 1720223571
- Provider Name
- MICHAEL PAUL DOERFLEIN LCSW
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2015 THOMAS ST. HOUSTON, TX 77009
- Location Phone
- (713) 873-4029
- Location Fax
- (832) 203-5115
- Mailing Address
- 5003 OAK SHADOWS DR HOUSTON, TX 77091
- Mailing Phone
- (832) 203-5115
- Mailing Fax
- (832) 203-5115
- Medical School Name
- OTHER
- Graduation Year
- 1999
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 12-09-2008
- Last Update Date
- 12-09-2008
- Code Navigator
A social worker like Michael Doerflein helps patients solve and cope with problems in their everyday lives, diagnoses and treats mental, behavioral, and emotional problems. Social workers help in wide range of situations, such as adopting a child, illness, divorce, or unemployment.
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
Social Worker
- Taxonomy Code
- 104100000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 30466
- License State
- TX
- Taxonomy Description
- A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 10: $0 PCP at Aetna network & MinuteClinic Primary Care + $0 CVS Health Virtual Care - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Silver 10: $0 PCP at Aetna network & MinuteClinic Primary Care + $0 CVS Health Virtual Care - HMO
- Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Clear VALUE Silver - HMO
- Complete VALUE Gold - HMO
- Focused VALUE Silver - HMO
- Focused VALUE Silver + Vision + Adult Dental - HMO
- Standard Gold VALUE - HMO
- Standard Silver VALUE - HMO
- Standard Silver VALUE + Vision + Adult Dental - HMO
- Complete VALUE Gold - HMO
- Complete VALUE Silver - HMO
- Elite VALUE Bronze - HMO
- Focused VALUE Silver - HMO
- Standard Expanded Bronze VALUE - HMO
- Standard Gold VALUE - HMO
- Standard Silver VALUE - HMO
- Connect Bronze 5500 Indiv Med Deductible - HMO
- Connect Bronze 6000 Indiv Med Deductible - HMO
- Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - HMO
- Connect Bronze 8500 Indiv Med Deductible - HMO
- Connect Bronze CMS Standard - HMO
- Connect Bronze DFW 6500 Indiv Med Deductible Enhanced Diabetes Care - HMO
- Connect Gold 1000 Indiv Med Deductible - HMO
- Connect Gold 2500 Indiv Med Deductible Enhanced Diabetes Care - HMO
- Connect Gold 3250 Indiv Med Deductible - HMO
- Connect Gold 3500 Indiv Med Deductible - HMO
- Community Premier Bronze 003 (No deductible for PCP, Free Preventive Care, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Bronze 018 (No deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Gold 005 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Gold 021 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Silver 012 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Silver 020 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Imperial Preferred Bronze - HMO
- Imperial Preferred Gold - HMO
- Imperial Preferred Gold Zero - HMO
- Imperial Preferred Silver - HMO
- Imperial Standard Bronze - HMO
- Imperial Standard Gold - HMO
- Imperial Standard Silver - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 12 - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic - EPO
- Gold Classic Guided Care - HMO
- Gold Classic Standard - EPO
- Gold Classic Standard Guided Care - HMO
- Gold Elite - EPO
- Gold Simple Guided Care - HMO
- Silver Classic - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Michael Doerflein is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Michael Doerflein is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
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.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 345500195
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20180216000273
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 7 | 2 | 0 | 2 | 2 | 3 | 5 | 7 | 1 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 7 | 4 | 0 | 4 | 2 | 6 | 5 | 14 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 7 + 4 + 0 + 4 + 2 + 6 + 5 + 1 + 4 + 24 = 59 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 59 = 1 | 1 |
The NPI number 1720223571 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720223571, enumerated in the NPI registry as an "individual" on December 09, 2008
The provider is located at 2015 Thomas St. Houston, Tx 77009 and the phone number is (713) 873-4029
The provider's speciality is Social Worker with taxonomy code 104100000X
The provider has more than 27 years of experience.
The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Superior. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
This NPI record was last updated on December 09, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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