Kaitlin Smith, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

024325-01 Issued in NY

Practice address

884 Brighton Rd
Tonawanda, NY 14150-8169

Phone

(716) 836-9460

Fax

(716) 836-9460

NPI assigned

Sep 11, 2015

Last updated

Feb 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

State of New York Comptrollers OfficeGroup PAC ID 0840101770, 171 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  Medicare reassignment Care Compare group NPD
• Kaitlin Smith PHD Psychologist PLLC

  • Clinic/Center
  • Tonawanda, NY
  • NPI 1194472613
  NPD Authorized official
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Corinth, NY
  • NPI 1003957424
  NPD
• Buffalo Behavioral Psychology, PC

  • Clinical Neuropsychologist
  • Williamsville, NY
  • NPI 1316313265
  NPD (past)

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1043688740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 BRIGHTON RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508169",
            "telephone_number": "716-836-9460",
            "fax_number": "716-836-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 BRIGHTON RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508169",
            "telephone_number": "716-836-9460",
            "fax_number": "716-836-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KAITLIN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024326",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "024325-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beata Caroline Skonecki, LCSW
• Kelsey Slavik, LMSW
• Sleep Pathways Inc
• Katherine Smielecki
• Chenelle Smith
• Laura Lee Smith, FNP
• Matthew Christopher Smith, PT, DPT
• Tera Smith
• Donna Snopkowski
• Janice Lynn Snyder, MS, OT

• Clinical Neuropsychologist in Tonawanda, NY
• Providers in Tonawanda, NY by specialty
• Clinical Neuropsychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.