Active NPI
Kristin J Tatrow, PH.D.
- Clinical Psychologist
- Fountainville, PA
National Provider Identifier
1437256856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS015768
- 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, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PY11803 | FL | MD | Clinical Psychologist |
| 015738 | NY | MD | Clinical Psychologist |
| PS015768 | PA | MD | Clinical 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.