Individual provider Active NPI

Alexis Raquepau Zubrod, PH. D.

  • Clinical Psychologist
  • St Petersburg, FL
National Provider Identifier
1477609394
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 6234 Issued in FL
Practice address
926 16TH St N
St Petersburg, FL 33705-1211
Phone
(727) 238-2335
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 6234 FL Primary

Addresses

Primary practice location

926 16TH St N
St Petersburg, FL 33705-1211

Mailing address

3501 Coquina Key Dr SE
St Petersburg, FL 33705-4115
Phone (727) 481-8101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20091009000017 FL Practitioner - Clinical Psychologist 2860538592 Practice locations: St Petersburg, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Pennsylvania State University College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

926 16TH St N
St Petersburg, FL 33705-1211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY 6234FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Psychology Clinical Past Accepting new patients
Emergent Care Psychologists PA Clinical Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1477609394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 COQUINA KEY DR SE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337054115",
            "telephone_number": "727-481-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 16TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051211",
            "telephone_number": "727-238-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUBROD",
        "first_name": "ALEXIS",
        "middle_name": "RAQUEPAU",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 6234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.