Individual provider Active NPI

Kenneth Lloyd Grill, PH.D.

  • Clinical Psychologist
  • Delray Beach, FL
National Provider Identifier
1093772014
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0003910 Issued in FL
Practice address
1690 S. Congress Ave.
Suite 100
Delray Beach, FL 33445-6327
Phone
(561) 488-7771
Fax
(561) 477-3634
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY0003910 FL Primary

Addresses

Primary practice location

1690 S. Congress Ave.
Suite 100
Delray Beach, FL 33445-6327

Mailing address

22282 Vista Lago Dr.
Boca Raton, FL 33428-4764
Phone (561) 477-3453

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
I20101022000674 FL Practitioner - Clinical Psychologist 0345433348 Practice locations: Boca Raton, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7900 Glades Rd
Boca Raton, FL 33434-4104
Phone (561) 488-7771

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY0003910FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jan M Burte PHD PA Clinical Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1093772014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22282 VISTA LAGO DR.",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284764",
            "telephone_number": "561-477-3453",
            "fax_number": "561-477-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 S. CONGRESS AVE.",
            "address_2": "SUITE 100",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334456327",
            "telephone_number": "561-488-7771",
            "fax_number": "561-477-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILL",
        "first_name": "KENNETH",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0003910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.