Katie A Ugolini, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1403 Issued in OR

Practice address

16110 SW Regatta LN
Beaverton, OR 97006-8942

Phone

(503) 617-6810

Fax

(503) 536-6794

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Katie Ugolini PHD LLC

  • Adult Mental Health Clinic/Center
  • Beaverton, OR
  • NPI 1164131603
  Medicare reassignment NPD
• Northwest Occupational Medicine Center Inc.

  • Multi-Specialty Clinic/Center
  • Beaverton, OR
  • NPI 1407882772
  NPD (past)
• NW Occupational Medicine Center

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1790921534
  NPD (past)
• Wildwood Psychiatric Resource Center

  • Psychologist
  • Beaverton, OR
  • NPI 1235181868
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1346267184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 NE 25TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972116106",
            "telephone_number": "503-617-6810",
            "fax_number": "503-536-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16110 SW REGATTA LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068942",
            "telephone_number": "503-617-6810",
            "fax_number": "503-536-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UGOLINI",
        "first_name": "KATIE",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "054123028",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "293389",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.