Active NPI
Katherine Brazaitis, PHD
- Clinical Psychologist
- Tucson, AZ
National Provider Identifier
1285185199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4778
- Practice address
- 3601 S 6TH Ave
4-116E
Tucson, AZ 85723-0001 - Phone
- (520) 792-1450
- NPI assigned
- Oct 17, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4778 | AZ | Primary |
Addresses
Primary practice location
3601 S 6TH Ave
4-116E
Tucson, AZ 85723-0001
Mailing address
3601 S 6TH Ave
4-116E
Tucson, AZ 85723-0001
Phone (520) 792-1450
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
152 Bay Ridge Pkwy
Apt 1
Brooklyn, NY 11209-2351
Phone (443) 756-4028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4778 | AZ | MD | General Practice Dentistry |
| 026995 | NY | MD | Massage Therapist |
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": "1476662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476662400000",
"number": "1285185199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 S 6TH AVE",
"address_2": "4-116E",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857230001",
"telephone_number": "520-792-1450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 S 6TH AVE",
"address_2": "4-116E",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857230001",
"telephone_number": "520-792-1450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAZAITIS",
"first_name": "KATHERINE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-17",
"last_updated": "2016-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "4778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.