Rena Peterson, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY7702 Issued in FL

Practice address

1971 Lee Rd
Winter Park, FL 32789-1870

Phone

(407) 450-8151

NPI assigned

May 3, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Rena Stacy Former name

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

Specialty

Clinical Psychologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Behavioral Health Minute Clinic LLCGroup PAC ID 2860726114, 2 clinicians

Sailor Health Medical PAGroup PAC ID 4486182342, 301 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Behavioral Health Minute Clinic LLC

  • Group Psychotherapy Psychologist
  • Winter Park, FL
  • NPI 1336704154
  Medicare reassignment Care Compare group NPD Authorized official
• Sailor Health Medical PA

  • Psychologist
  • Coral Gables, FL
  • NPI 1841012960
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1209772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1306012919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 WOLDUNN CIR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465914",
            "telephone_number": "561-702-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 LEE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891870",
            "telephone_number": "407-450-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RENA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-03",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENA",
            "last_name": "STACY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Louis Pesce, D.D.S.
• Peter G. Lemieux DMD, PA
• Alexis Peters, PT, DPT, ATC
• Celestina Peters, ARNP
• Kristi Lynn Peterson
• Mary Monica Petith, PH.D.
• Andrijana Petreska, BSN, RN
• Monica Pevida, MD
• Elizabeth Pezdek, ARNP
• Maria Wells Pezzoli, PHARMD

• Psychologist in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.