Kristen Elaine Holderle, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

016808 Issued in NY

Practice address

1175 Pittsford Victor Rd
Suite 100
Pittsford, NY 14534-3811

Phone

(585) 797-7084

Fax

(844) 626-2450

NPI assigned

Nov 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Kristen Holderle Davidson Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Rochester Department of Psychiatry Clinical GroupGroup PAC ID 3173420429, 80 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• University of Rochester Department of Psychiatry Clinical Group

  • Psychiatry Physician
  • Rochester, NY
  • NPI 1326088808

  Psychologist

  Medicare reassignment Care Compare group NPD
• Adult Complex Care Center

  • Primary Care Clinic/Center
  • Rochester, NY
  • NPI 1053778654
  Medicare reassignment NPD
• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1710226824
  Medicare reassignment NPD
• Acute Care Trauma of the University of Rochester

  • Surgical Critical Care Physician
  • Rochester, NY
  • NPI 1851754634
  NPD
• Cardiac Surgery of the University of Rochester

  • Surgical Critical Care Physician
  • Rochester, NY
  • NPI 1689023277
  NPD
• University of Rochester

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1598476269
  NPD
• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1962928341
  NPD

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1356420939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 PITTSFORD VICTOR RD",
            "address_2": "SUITE 100",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145343811",
            "telephone_number": "585-797-7084",
            "fax_number": "844-626-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 PITTSFORD VICTOR RD",
            "address_2": "SUITE 100",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145343811",
            "telephone_number": "585-797-7084",
            "fax_number": "844-626-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDERLE",
        "first_name": "KRISTEN",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-07-05",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "16808",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "016808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "18954FC",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7161860",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS ROCHESTER REGION",
            "identifier": "P010016808",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdavidson6963@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdavidson6963@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "DAVIDSON",
            "middle_name": "HOLDERLE",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ronald Neil Heinle, D.D.S.
• Anne Marie Jurenko Herron, LMT
• Abigail R Hilkert, RBT
• Jordan R Hodge, DPT
• Debra S. Hoffman, PH.D.
• Nicholas Holub, PSYD, MSW
• Martin Hoogendijk
• Robert Edwin Horn, MD
• Gary J. Horwitz, M.D.
• Eve Hosford, LCSW-R

• Psychologist in Pittsford, NY
• Providers in Pittsford, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.