Individual provider Active NPI

Regina Santelli, PHD

  • Clinical Psychologist
  • Phoenix, AZ
National Provider Identifier
1205094653
Registry record updated May 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3873 Issued in AZ
Practice address
5125 N 16TH St Ste A102
Phoenix, AZ 85016-3926
Phone
(602) 324-4676
Fax
(602) 283-5306
NPI assigned
May 31, 2008
Last updated
May 31, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2008

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 3873 AZ Primary

Addresses

Primary practice location

5125 N 16TH St Ste A102
Phoenix, AZ 85016-3926

Mailing address

5125 N 16TH St Ste A102
Phoenix, AZ 85016-3926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, AZ2 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
I20040415000931 PA Practitioner - Clinical Psychologist 4183619653 Practice locations: Mars, PA; Wexford, PA
I20080625000341 AZ Practitioner - Clinical Psychologist 4183619653

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

195 Crowe Ave
Mars, PA 16046-3303
Phone (412) 719-5434

6200 Brooktree Rd
Suite 310
Wexford, PA 15090-9299
Phone (724) 252-4637

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3873AZMDChild Mental Illness Respite Care

Practice roles

OrganizationSpecialtyStatusNew patients
Encompass Health Services, Inc CurrentSince Oct 1, 2018 Accepting new patients
New Prespectives Pychological Services, Inc. Clinical Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212192000000",
    "number": "1205094653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 N 16TH ST STE A102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 N 16TH ST STE A102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163926",
            "telephone_number": "602-324-4676",
            "fax_number": "602-283-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTELLI",
        "first_name": "REGINA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-31",
        "last_updated": "2008-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.