Katrina Blomquist, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

950 Danby Rd Ste 202F
Ithaca, NY 14850-5714

Phone

(607) 260-3100

NPI assigned

Aug 18, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 8, 2022 through Dec 8, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Mindwell Psychology, LLP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ithaca, NY
  • NPI 1255944377
  NPD
• Mindwell Psychological Assessment, LLP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Latham, NY
  • NPI 1902536410
  NPD (past)

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1659770535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 DANBY RD STE 202F",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505714",
            "telephone_number": "607-260-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 DANBY RD STE 202F",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505714",
            "telephone_number": "607-260-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOMQUIST",
        "first_name": "KATRINA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily L Blair
• Kathleen M Blair, MASTER OF SOCIAL WOR
• Deidre Blake, M.D.
• Alison Bliss
• Althea Blodgett-Gallahan, RN, CNM
• Joseph Blood, PAC
• Bloom Speech Therapy, PLLC
• Tanya Sarah Bloom, OD
• Ariana Marie Blossom, LMT
• Donald G Bluh, MD

• Clinical Child & Adolescent Psychologist in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Clinical Child & Adolescent Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.