Individual provider Active NPI

Amreeta Gill, PSYD

  • Clinical Psychologist
  • Saint Joseph, MI
National Provider Identifier
1770990392
Registry record updated Oct 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301017820 Issued in MI
Practice address
415 Main St Ste a
Saint Joseph, MI 49085-3100
Phone
(269) 408-1688
NPI assigned
Jul 15, 2014
Last updated
Oct 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301017820 MI Primary
Clinical Psychologist 103TC0700X 33042 CA

Addresses

Primary practice location

415 Main St Ste a
Saint Joseph, MI 49085-3100

Mailing address

415 Main St Ste a
Saint Joseph, MI 49085-3100
Phone (269) 408-1688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190507000118 MI Practitioner - Clinical Psychologist 2264774595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatric Specialties, PLCGroup PAC ID 5799729265, 10 clinicians

Practice addresses (Care Compare)

1030 Miners Rd
Saint Joseph, MI 49085-9709

415 Main St
Suite a
Saint Joseph, MI 49085-3100
Phone (269) 408-1688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Specialties, PLC Clinical CurrentSince Mar 27, 2019 Accepting new patients

Locations

1030 Miners Rd
Saint Joseph, MI 49085
Phone (269) 408-1688

415 Main St
Ste A
Saint Joseph, MI 49085
Phone (269) 408-1688

Interoperability endpoints

  • Direct secure messaging: amreeta.gill.1@27120.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/27120/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665273600000",
    "number": "1770990392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MAIN ST STE A",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853100",
            "telephone_number": "269-408-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST STE A",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853100",
            "telephone_number": "269-408-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "AMREETA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2022-10-09",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301017820",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.