Individual provider Active NPI

Aleksandr A Kronik, PH.D., SC.D.

  • Clinical Psychologist
  • Rockville, MD
National Provider Identifier
1336276476
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
04137 Issued in MD
Practice address
5801 Nicholson LN Apt 1125
Rockville, MD 20852-5734
Phone
(301) 320-0729
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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 04137 MD Primary

Addresses

Primary practice location

5801 Nicholson LN Apt 1125
Rockville, MD 20852-5734

Mailing address

5801 Nicholson LN Apt 1125
Rockville, MD 20852-5734
Phone (301) 320-0729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20060322000400 DC Practitioner - Clinical Psychologist 2163430885 Reassigns benefits to 1 organization
Practice locations: Rockville, MD
I20210408000043 MD Practitioner - Clinical Psychologist 2163430885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychogeriatric Services LLCGroup PAC ID 6002719226, 122 clinicians

Practice addresses (Care Compare)

12073 Tech Rd
Suite B
Silver Spring, MD 20904-7874
Phone (301) 593-1315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04137MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychogeriatric Services LLC CurrentSince Mar 11, 2021 Accepting new patients

Locations

4101 Old National Pike
Mount Airy, MD 21771
Phone (301) 829-0800

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1336276476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 NICHOLSON LN APT 1125",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208525734",
            "telephone_number": "301-320-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 NICHOLSON LN APT 1125",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208525734",
            "telephone_number": "301-320-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRONIK",
        "first_name": "ALEKSANDR",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D., SC.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.