Active NPI
Kelly S Demartini, PH.D.
- Clinical Psychologist
- New Haven, CT
National Provider Identifier
1710287909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 003299
- Practice address
- 20 York St
New Haven, CT 06510-3220 - Phone
- (203) 974-5784
- NPI assigned
- Oct 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 003299 | CT | Primary |
Addresses
Primary practice location
20 York St
New Haven, CT 06510-3220
Mailing address
1 Long Wharf Dr
Box 18
New Haven, CT 06511-5991
Phone (203) 074-5784
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
40 Temple St
Suite 1a
New Haven, CT 06510-2715
Phone (203) 785-4138
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.36 of 100
- Quality
- 77.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.27
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003299 | CT | MD | Clinical Psychologist |
| 3299 | CT | MD | Physician Assistant |
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.
-
- Anesthesiology Physician
- New Haven, CT
- NPI 1205822236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426636800000",
"number": "1710287909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LONG WHARF DR",
"address_2": "BOX 18",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115991",
"telephone_number": "203-074-5784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 YORK ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065103220",
"telephone_number": "203-974-5784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMARTINI",
"first_name": "KELLY",
"middle_name": "S",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-22",
"last_updated": "2015-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "003299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.