Individual provider Active NPI

Erica Ailes, PSYD

  • Psychologist
  • Sarasota, FL
National Provider Identifier
1356021117
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY11977 Issued in FL
Practice address
1515 S Osprey Ave Ste A1
Sarasota, FL 34239-2933
Phone
(941) 917-7197
Fax
(941) 917-4016
NPI assigned
Jul 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PPY353 FL
Psychologist 103T00000X PY11977 FL Primary

Addresses

Primary practice location

1515 S Osprey Ave Ste A1
Sarasota, FL 34239-2933

Mailing address

PO Box 947407
Atlanta, GA 30394-7407

Other practice location 1

5860 Ranch Lake Blvd
Lakewood Ranch, FL 34202-3718
Phone (941) 388-8997

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240425001122 FL Practitioner - Clinical Psychologist 8426498312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1515 S Osprey
Suite 1 a
Sarasota, FL 34239-2933
Phone (941) 917-7197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PPY353FLMDPsychologist
PY11977FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc CurrentSince May 27, 2024 Accepting new patients

Locations

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1515 S Osprey Ave
Ste A1
Sarasota, FL 34239
Phone (941) 917-7197

Interoperability endpoints

  • Direct secure messaging: erica.ailes@fpg.directbygreenway.com

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": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1356021117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S OSPREY AVE STE A1",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392933",
            "telephone_number": "941-917-7197",
            "fax_number": "941-917-4016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5860 Ranch Lake Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakewood Ranch",
            "state": "FL",
            "postal_code": "342023718",
            "country_code": "US",
            "telephone_number": "941-388-8997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AILES",
        "first_name": "ERICA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PPY353",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY11977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.