Active NPI
Scott Matthew Krysztofiak, PSY.D.
- Clinical Psychologist
- Alexandria, VA
National Provider Identifier
1801284682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810005093
- Practice address
- 5500 Holmes Run Pkwy
Suite C 4
Alexandria, VA 22304-2863 - Phone
- (703) 379-7350
- Fax
- (703) 379-7352
- NPI assigned
- Jan 2, 2015
- Sex
- Male
- 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 | 0810005093 | VA | Primary |
Addresses
Primary practice location
5500 Holmes Run Pkwy
Suite C 4
Alexandria, VA 22304-2863
Mailing address
5500 Holmes Run Pkwy
Suite C 4
Alexandria, VA 22304-2863
Phone (703) 379-7350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- 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
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5500 Holmes Run Pkwy
Suite C4
Alexandria, VA 22304-2860
Phone (703) 379-7350
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Potomac Center Inc | Clinical | Current | Accepting new patients |
Locations
5500 Holmes Run Pkwy
Ste C4
Alexandria, VA 22304
Phone (703) 379-7350
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420156800000",
"number": "1801284682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5500 HOLMES RUN PKWY",
"address_2": "SUITE C 4",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223042863",
"telephone_number": "703-379-7350",
"fax_number": "703-379-7352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 HOLMES RUN PKWY",
"address_2": "SUITE C 4",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223042863",
"telephone_number": "703-379-7350",
"fax_number": "703-379-7352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRYSZTOFIAK",
"first_name": "SCOTT",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-02",
"last_updated": "2015-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810005093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.