Individual provider Active NPI

Kristin J Tatrow, PH.D.

  • Clinical Psychologist
  • Fountainville, PA
National Provider Identifier
1437256856
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS015768 Issued in PA
Practice address
5055 Swamp Rd Ste 202
Fountainville, PA 18923-9655
Phone
(215) 257-1633
Fax
(267) 867-7526
NPI assigned
Sep 20, 2006
Last updated
May 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 015738 NY
Clinical Psychologist 103TC0700X PS015768 PA Primary
Clinical Psychologist 103TC0700X PY11803 FL

Addresses

Primary practice location

5055 Swamp Rd Ste 202
Fountainville, PA 18923-9655

Mailing address

PO Box 104
Fountainville, PA 18923-0104
Phone (215) 257-1633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20051214000550 PA Practitioner - Clinical Psychologist 5597786863 Practice locations: Fountainville, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5055 Swamp Rd
Suite 202
Fountainville, PA 18923-9655
Phone (215) 257-1633

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY11803FLMDClinical Psychologist
015738NYMDClinical Psychologist
PS015768PAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1437256856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104",
            "city": "FOUNTAINVILLE",
            "state": "PA",
            "postal_code": "189230104",
            "telephone_number": "215-257-1633",
            "fax_number": "267-867-7526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 SWAMP RD STE 202",
            "city": "FOUNTAINVILLE",
            "state": "PA",
            "postal_code": "189239655",
            "telephone_number": "215-257-1633",
            "fax_number": "267-867-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATROW",
        "first_name": "KRISTIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015738",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS015768",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11803",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountainville, PA

Sources for this page

Verify at the official NPI Registry.