Individual provider Active NPI

Vidhi M Thakkar, PSYD

  • Clinical Psychologist
  • Winter Park, FL
National Provider Identifier
1750907192
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY12734 Issued in FL
Practice address
1801 Lee Rd Ste 165
Winter Park, FL 32789-2127
Phone
(407) 821-3547
Fax
(407) 821-3548
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY12734 FL Primary
Clinical Psychologist 103TC0700X 6236 NC
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1801 Lee Rd Ste 165
Winter Park, FL 32789-2127

Mailing address

1801 Lee Rd Ste 165
Winter Park, FL 32789-2127
Phone (407) 821-3547

Other practice location 1

Medical Center Blvd
Winston Salem, NC 27157-6062
Phone (336) 716-9253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, 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
I20241223000424 NC Practitioner - Clinical Psychologist 1759818230
I20250923000645 FL Practitioner - Clinical Psychologist 1759818230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1801 Lee Rd
Suite 165
Winter Park, FL 32789-2101

900 Hope Way
Altamonte Springs, FL 32714-1502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY12734FLMDClinical Psychologist
6236NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Oct 20, 2025 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Oct 20, 2025 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1801 Lee Rd
Ste 165
Winter Park, FL 32789
Phone (407) 975-0406

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": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1750907192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 LEE RD STE 165",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892127",
            "telephone_number": "407-821-3547",
            "fax_number": "407-821-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LEE RD STE 165",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892127",
            "telephone_number": "407-821-3547",
            "fax_number": "407-821-3548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271576062",
            "country_code": "US",
            "telephone_number": "336-716-9253",
            "fax_number": "336-713-4501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "VIDHI",
        "middle_name": "M",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY12734",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "6236",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.