Individual provider Active NPI

Stacey Ilene Kaltman, PHD

  • Clinical Psychologist
  • Washington, DC
National Provider Identifier
1811059207
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY1000157 Issued in DC
Practice address
3800 Reservoir Rd NW
613 Kober Cogan Hall
Washington, DC 20007-2113
Phone
(202) 687-6571
Fax
(202) 687-0694
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY1000157 DC Primary
Clinical Psychologist 103TC0700X 0810002920 VA

Addresses

Primary practice location

3800 Reservoir Rd NW
613 Kober Cogan Hall
Washington, DC 20007-2113

Mailing address

5225 Pooks Hill Rd
Apt 820S
Bethesda, MD 20814-2052
Phone (301) 493-4582

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130520000584 DC Practitioner - Clinical Psychologist 1052558640 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (202) 444-2000

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810002920VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Mar 1, 2024 Accepting new patients
Medstar - Georgetown Medical Center, Inc. CurrentSince Feb 5, 2013 Accepting new patients
Medstar Georgetown Medical Center, Inc CurrentSince Feb 5, 2013 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3800 Reservoir Rd NW
#613
Washington, DC 20007
Phone (202) 687-6571

2115 Wisconsin Ave NW
Ste 200
Washington, DC 20007
Phone (202) 944-5400

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

Organizations & group practices 3

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811059207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 POOKS HILL RD",
            "address_2": "APT 820S",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142052",
            "telephone_number": "301-493-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "address_2": "613 KOBER COGAN HALL",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-687-6571",
            "fax_number": "202-687-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALTMAN",
        "first_name": "STACEY",
        "middle_name": "ILENE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1000157",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.