Individual provider Active NPI

Raymond D Martorano, PHD

  • Clinical Psychologist
  • Louisville, KY
National Provider Identifier
1700974540
Registry record updated May 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
129056 Issued in KY
Practice address
8007 Lyndon Centre Way Ste 101
Louisville, KY 40222-3608
Phone
(502) 690-8024
Fax
(502) 690-8090
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 167029 KY
Clinical Psychologist 103TC0700X 129056 KY Primary

Addresses

Primary practice location

8007 Lyndon Centre Way Ste 101
Louisville, KY 40222-3608

Mailing address

8007 Lyndon Centre Way
Suite # 101
Louisville, KY 40222
Phone (502) 690-8024

Other practice location 1

120 Prosperous Pl Ste 207
Lexington, KY 40509-1866
Phone (502) 735-1924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080521000029 KY Practitioner - Clinical Psychologist 9032288782 Practice locations: Lexington, KY
I20230313000074 FL Practitioner - Clinical Psychologist 9032288782 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
167029KYMDAddiction (Substance Use Disorder) Psychologist
129056KYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Che Behavioral Health Services of Florida, P.a. Clinical CurrentSince Jan 29, 2023 Accepting new patients
Keith Haas, LCSW, PLLC PastSince Jun 6, 2017 Accepting new patients

Locations

6750 N Andrews Ave
Ste 200
Lauderdale Lakes, FL 33309
Phone (718) 408-5477

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685145600000",
    "number": "1700974540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8007 LYNDON CENTRE WAY",
            "address_2": "SUITE # 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40222",
            "telephone_number": "502-690-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8007 LYNDON CENTRE WAY STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223608",
            "telephone_number": "502-690-8024",
            "fax_number": "502-690-8090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Prosperous Pl Ste 207",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405091866",
            "country_code": "US",
            "telephone_number": "502-735-1924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTORANO",
        "first_name": "RAYMOND",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-05-27",
        "certification_date": "2023-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "167029",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "129056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.