Individual provider Active NPI

Logan Kaleta, PSYD, CIC

  • Clinical Neuropsychologist
  • Fort Lauderdale, FL
National Provider Identifier
1104293109
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY10205 Issued in FL
Practice address
5597 N Dixie Hwy
Fort Lauderdale, FL 33334
Phone
(954) 958-4800
NPI assigned
Aug 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY10205 FL
Clinical Neuropsychologist 103G00000X PY10205 FL Primary

Addresses

Primary practice location

5597 N Dixie Hwy
Fort Lauderdale, FL 33334

Mailing address

5597 N Dixie Hwy
Oakland Park, FL 33334-3406
Phone (954) 958-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151008001856 GA Practitioner - Clinical Psychologist 6406164508 Reassigns benefits to 1 organization
I20190212002118 FL Practitioner - Clinical Psychologist 6406164508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holy Cross Hospital IncGroup PAC ID 1850298365, 299 clinicians

Practice addresses (Care Compare)

1000 NE 56TH St
Holy Cross Medical Group
Oakland Park, FL 33334-4149
Phone (954) 489-4576

1000 NE 56TH St FL
2 Holy Cross Medical Group
Ft Lauderdale, FL 33334-4149
Phone (954) 958-0626

1000 NE 56TH St Womens Ctr
Holy Cross Medical Group
Ft Lauderdale, FL 33334-4149
Phone (954) 229-8660

1309 S Federal Hwy
Holy Cross Medical Group
Fort Lauderdale, FL 33316-2040
Phone (954) 463-4383

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Sep 1, 2015 Accepting new patients
Holy Cross Hospital Inc CurrentSince Oct 1, 2018 Accepting new patients
Link Performance LLC Clinical Neuropsychologist CurrentSince Dec 31, 2024 Accepting new patients
Holy Cross Hospital, Inc CurrentSince Oct 1, 2018 Accepting new patients

Locations

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

5597 N Dixie Hwy
Oakland Park, FL 33334
Phone (954) 267-6390

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1104293109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5597 N DIXIE HWY",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333343406",
            "telephone_number": "954-958-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5597 N DIXIE HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33334",
            "telephone_number": "954-958-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALETA",
        "first_name": "LOGAN",
        "credential": "PSYD, CIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10205",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY10205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.