Individual provider Active NPI

Stefanie Paliatsos, PH.D.

  • Clinical Psychologist
  • Jacksonville, FL
National Provider Identifier
1821221615
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7194 Issued in FL
Practice address
836 Prudential Dr Ste 1006
Jacksonville, FL 32207-8337
Phone
(904) 376-3800
Fax
(904) 390-7401
NPI assigned
Aug 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY7194 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1006
Jacksonville, FL 32207-8337

Mailing address

PO Box 748519
Atlanta, GA 30374-8519
Phone (904) 376-3800

Other practice location 1

1747 Baptist Clay Dr Ste 350
Fleming Island, FL 32003-8504
Phone (904) 376-3800

Other names 1

  • Stefanie Schwartz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200110000320 FL Practitioner - Clinical Psychologist 7315292190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Behavioral Health LLCGroup PAC ID 7315166394, 120 clinicians

Practice addresses (Care Compare)

836 Prudential Dr
Suite 1006
Jacksonville, FL 32207-8337
Phone (904) 376-3800

Merit-based Incentive Payment System (MIPS)

Final score
89.95 of 100Reported as group
Quality
84.69
Promoting interoperability
100
Improvement activities
40
Cost
74.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY7194FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Behavioral Health, LLC CurrentSince Oct 28, 2019 Accepting new patients
Southern Baptist Hospital of Florida Inc Past Accepting new patients

Locations

1747 Baptist Clay Dr
Ste 350
Fleming Island, FL 32003

836 Prudential Dr
Ste 1006
Jacksonville, FL 32207
Phone (904) 202-1795

820 Prudential Dr
Ste 510
Jacksonville, FL 32207

1660 Prudential Dr
Ste 410
Jacksonville, FL 32207

87010 Professional Way
Yulee, FL 32097

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": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1821221615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800",
            "fax_number": "904-376-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1006",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078337",
            "telephone_number": "904-376-3800",
            "fax_number": "904-390-7401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1747 Baptist Clay Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320038504",
            "country_code": "US",
            "telephone_number": "904-376-3800",
            "fax_number": "904-390-7397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALIATSOS",
        "first_name": "STEFANIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "SCHWARTZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.