Individual provider Active NPI

Jay Trambadia, PSYD

  • Clinical Psychologist
  • Marietta, GA
National Provider Identifier
1306253919
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY003807 Issued in GA
Practice address
55 Whitcher St NE Ste 420
Marietta, GA 30060-1171
Phone
(770) 514-6760
Fax
(770) 794-8034
NPI assigned
Jul 15, 2014
Last updated
Oct 31, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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 PSY003807 GA Primary

Addresses

Primary practice location

55 Whitcher St NE Ste 420
Marietta, GA 30060-1171

Mailing address

805 Sandy Plains Road
Medical Staff Services
Marietta, GA 30066-6340

Other practice location 1

2659 Forest Way NE
Marietta, GA 30066-1492
Phone (678) 464-2648

Other identifiers 1

IdentifierTypeStateIssuer
003807OtherGAGEORGIA PSYCHOLOGY BOARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jtrambadia338687@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20150209001154 GA Practitioner - Clinical Psychologist 8224353537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

55 Whitcher Nest
Marietta, GA 30060-1129

55 Whitcher St
Marietta, GA 30060-1129

55 Whitcher St NE
Suite 400
Marietta, GA 30060-1129
Phone (470) 956-3960

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY003807GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince May 10, 2019 Accepting new patients
Wellstar Medical Group, LLC CurrentSince May 10, 2019 Accepting new patients
City of Hope Medical Group of Georgia LLC CurrentSince Jul 23, 2014 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

55 Whitcher St NE
Ste 420
Marietta, GA 30060
Phone (770) 514-6760

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

62742 Collections Ctr Dr
Chicago, IL 60693

Interoperability endpoints

  • Direct secure messaging: jtrambadia338687@directwellstar.org

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, 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": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1306253919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SANDY PLAINS ROAD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 420",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601171",
            "telephone_number": "770-514-6760",
            "fax_number": "770-794-8034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2659 Forest Way NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300661492",
            "country_code": "US",
            "telephone_number": "678-464-2648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAMBADIA",
        "first_name": "JAY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-15",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA PSYCHOLOGY BOARD",
            "identifier": "003807",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtrambadia338687@directwellstar.org",
            "affiliation": "N",
            "address_1": "55 Whitcher St NE Ste 420",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.