CMS-1500 Box 24J / 33a • NPI
1093966541
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
103T00000X (CMS 62)
Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist
Box 32 Service Location & ZIP+4
628 FOREST TRL, ARGYLE, TX, 76226-6705
✓ 9-Digit EDI 837 ZIP+4 (76226-6705)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1093966541 (CHARLES CLIFFORD BORSELLINO, Ph.d.,Psy.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
No
Power Mobility
No
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1093966541)
Medicare Beneficiaries
40
Total Billed Services
1,379
Distinct CPT/HCPCS Codes
4
Medicare Allowed Total
$129,549.44
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
90834 | Psychotherapy, 45 minutes | 816 |
90834 | Psychotherapy, 45 minutes | 528 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1093966541 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | CHARLES CLIFFORD BORSELLINO, Ph.d.,Psy.D. |
| Plain-English Specialty | Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist NUCC Code: 103T00000X (Psychologist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 628 FOREST TRL, ARGYLE, TX, 76226-6705 |
| Practice Telephone / Fax | Tel: (817) 966-3910 |
| Administrative Mailing Address | 628 FOREST TRL, ARGYLE, TX, 76226-6705 |
| Enumeration & Last Sync | Enumerated: 2008-10-02 | CMS Record Updated: 2026-11-01 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (103T00000X)
What Does Taxonomy Code 103T00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103T00000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (CHARLES CLIFFORD BORSELLINO, Ph.d.,Psy.D.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
103T00000X — PsychologistPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist | State: TX | License: 33874 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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