Individual provider Active NPI

Shannon Caramiello

  • Psychologist
  • Tarpon Springs, FL
National Provider Identifier
1043663982
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY10177 Issued in FL
Practice address
2611 Keystone Rd Ste B3
Tarpon Springs, FL 34688-7403
Phone
(727) 597-0977
Fax
(727) 205-4466
NPI assigned
Jul 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 10177 FL
Clinical Neuropsychologist 103G00000X 10177 FL
Psychologist 103T00000X PY10177 FL Primary
Clinical Psychologist 103TC0700X 10177 FL

Addresses

Primary practice location

2611 Keystone Rd Ste B3
Tarpon Springs, FL 34688-7403

Mailing address

2611 Keystone Rd Ste B3
Tarpon Springs, FL 34688-7403
Phone (727) 597-0977

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
I20190806001339 FL Practitioner - Clinical Psychologist 7214264860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keystone Psychological Services LLCGroup PAC ID 6901251248, 2 clinicians

Practice addresses (Care Compare)

155 E Tarpon Ave
Suite 4
Tarpon Springs, FL 34689-3451
Phone (727) 275-0282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY10177FLMDPsychologist
10177FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Caramiello, PSYD, LLC Clinical Neuropsychologist CurrentSince Jun 9, 2019 Accepting new patients
Keystone Psychological Services LLC Clinical Neuropsychologist CurrentSince Aug 29, 2023 Accepting new patients
Bay Area Neuropsychology, LLC Clinical Neuropsychologist PastSince Mar 1, 2013 Accepting new patients

Locations

210 S Pinellas Ave
Ste 245
Tarpon Springs, FL 34689
Phone (561) 305-7834

2611 Keystone Rd
Ste B3
Tarpon Springs, FL 34688
Phone (727) 275-0282

155 E Tarpon Ave
Ste 4
Tarpon Springs, FL 34689
Phone (727) 275-0282

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1043663982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 KEYSTONE RD STE B3",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346887403",
            "telephone_number": "727-597-0977",
            "fax_number": "727-205-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 KEYSTONE RD STE B3",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346887403",
            "telephone_number": "727-597-0977",
            "fax_number": "727-205-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARAMIELLO",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "FL",
            "license": "10177",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "10177",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY10177",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "10177",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

Verify at the official NPI Registry.