Anne Dominique Bartolucci, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY003003 Issued in GA

Practice address

315 W Ponce de Leon Ave
Suite 1051
Decatur, GA 30030-2400

Phone

(404) 378-0441

NPI assigned

Dec 15, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1437211430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE",
            "address_2": "SUITE 1051",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302400",
            "telephone_number": "404-378-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE",
            "address_2": "SUITE 1051",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302400",
            "telephone_number": "404-378-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTOLUCCI",
        "first_name": "ANNE",
        "middle_name": "DOMINIQUE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahalia Barrow
• Zana Barrow, PMHNP-BC
• Ann Jane Barry, P.T., C.H.T.
• Francis Harold Barry III, APRN, FNP-C
• Debra H Bartenfeld, RN
• Jennifer Barwick
• Kristian Barze
• Cristi Baskett
• Sue Ellen Basore, MS
• Mayesha R Bassett

• Psychologist in Decatur, GA
• Providers in Decatur, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.