Individual provider Active NPI

Karen K Estill, PHD

  • Clinical Neuropsychologist
  • Tavares, FL
National Provider Identifier
1043249998
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY3993 Issued in FL
Practice address
101 E Maud St
Tavares, FL 32778-3249
Phone
(352) 253-9348
Fax
(352) 253-9351
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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 PY3993 FL Primary

Addresses

Primary practice location

101 E Maud St
Tavares, FL 32778-3249

Mailing address

101 E Maud St
Tavares, FL 32778-3249
Phone (352) 253-9348

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
I20080319000337 FL Practitioner - Clinical Psychologist 6103902903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 E Maud St
Tavares, FL 32778-3249

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling & Development Center Inc CurrentSince Feb 20, 2013 Accepting new patients
Neuropsychology & Counseling Services PA Clinical Neuropsychologist CurrentSince Mar 7, 2008 Accepting new patients

Locations

101 E Maud St
Tavares, FL 32778
Phone (352) 253-9348

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1043249998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MAUD ST",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327783249",
            "telephone_number": "352-253-9348",
            "fax_number": "352-253-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MAUD ST",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327783249",
            "telephone_number": "352-253-9348",
            "fax_number": "352-253-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTILL",
        "first_name": "KAREN",
        "middle_name": "K",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY3993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.