Individual provider Active NPI

Patricia Calixte-Civil, PHD

  • Psychologist
  • Tampa, FL
National Provider Identifier
1568289353
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
12390 Issued in FL
Practice address
205 S Hoover Blvd
Tampa, FL 33609-3500
Phone
(813) 303-2742
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 12390 FL Primary

Addresses

Primary practice location

205 S Hoover Blvd
Tampa, FL 33609-3500

Mailing address

7253 Gennaker Dr
Tampa, FL 33607-5896
Phone (732) 737-1277

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
I20241003003970 FL Practitioner - Clinical Psychologist 2365973179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Psychological Services, PLLCGroup PAC ID 4587969977, 15 clinicians

Practice addresses (Care Compare)

205 S Hoover Blvd
Suite 202
Tampa, FL 33609-3574
Phone (813) 563-1155

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12390FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Psychological Services PLLC CurrentSince Sep 20, 2024 Accepting new patients

Locations

3637 4th St N
Ste 390
St Petersburg, FL 33704
Phone (727) 310-5520

205 S Hoover Blvd
Ste 202
Tampa, FL 33609
Phone (813) 563-1155

Organizations & group practices 1

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": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1568289353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7253 GENNAKER DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075896",
            "telephone_number": "732-737-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S HOOVER BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093500",
            "telephone_number": "813-303-2742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALIXTE-CIVIL",
        "first_name": "PATRICIA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "12390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.