Active NPI
Kristen Mordecai, PH.D.
- Clinical Neuropsychologist
- Baltimore, MD
National Provider Identifier
1437419280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 05086
- Practice address
- 10 N Greene St
VA Maryland Healthcare System
Baltimore, MD 21201-1524 - Phone
- (410) 637-1388
- NPI assigned
- May 25, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 05086 | MD | Primary |
Addresses
Primary practice location
10 N Greene St
VA Maryland Healthcare System
Baltimore, MD 21201-1524
Mailing address
914 Valencia CT
Baltimore, MD 21230-3966
Phone (773) 203-1949
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337904000000",
"number": "1437419280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 VALENCIA CT",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212303966",
"telephone_number": "773-203-1949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 N GREENE ST",
"address_2": "VA MARYLAND HEALTHCARE SYSTEM",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011524",
"telephone_number": "410-637-1388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORDECAI",
"first_name": "KRISTEN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-25",
"last_updated": "2012-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MD",
"license": "05086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.