Individual provider Active NPI

Jodi D Nadler, PHD

  • Clinical Neuropsychologist
  • Winter Park, FL
National Provider Identifier
1033146907
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY5236 Issued in FL
Practice address
1685 Lee Rd
Suite 200
Winter Park, FL 32789-2262
Phone
(407) 303-7991
Fax
(407) 303-7803
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY5236 FL Primary

Addresses

Primary practice location

1685 Lee Rd
Suite 200
Winter Park, FL 32789-2262

Mailing address

1685 Lee Rd
Suite 200
Winter Park, FL 32789-2262
Phone (407) 303-7991

Other identifiers 2

IdentifierTypeStateIssuer
620003409OtherRAILROAD MEDICARE
59758OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100211000307 FL Practitioner - Clinical Psychologist 4486797529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY5236FLMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Jun 1, 1998 Accepting new patients
Florida Hospital Medical Group Inc Clinical Neuropsychologist CurrentSince Jun 1, 1998 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1685 Lee Rd
Ste 200
Winter Park, FL 32789
Phone (407) 303-7991

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1033146907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 LEE RD",
            "address_2": "SUITE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892262",
            "telephone_number": "407-303-7991",
            "fax_number": "407-303-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 LEE RD",
            "address_2": "SUITE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892262",
            "telephone_number": "407-303-7991",
            "fax_number": "407-303-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADLER",
        "first_name": "JODI",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY5236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "620003409",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59758",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.