Individual provider Active NPI

Brad Palermo, PSY.D., LICENSED PSY

  • Clinical Psychologist
  • Tampa, FL
National Provider Identifier
1558567602
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 7877 Issued in FL
Practice address
322 W Bearss Ave
Tampa, FL 33613-1228
Phone
(786) 683-8866
NPI assigned
Jun 25, 2007
Last updated
Jun 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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 7877 FL Primary

Addresses

Primary practice location

322 W Bearss Ave
Tampa, FL 33613-1228

Mailing address

5841 NW Alpha CT
Port Saint Lucie, FL 34986-4100
Phone (786) 683-8866

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
I20090827000162 FL Practitioner - Clinical Psychologist 6608921622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

322 W Bearss Ave
Tampa, FL 33613-1228
Phone (888) 899-7736

526 S Main St
Wildwood, FL 34785-4832
Phone (888) 899-7736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindpath Solutions Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1558567602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 NW ALPHA CT",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349864100",
            "telephone_number": "786-683-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 W BEARSS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131228",
            "telephone_number": "786-683-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALERMO",
        "first_name": "BRAD",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LICENSED PSY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.