Active NPI
Paul Tritsos, PSYD
- Clinical Psychologist
- Panama City, FL
National Provider Identifier
1831174622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY6921
- Practice address
- 2680 Chapman Dr
Panama City, FL 32405-4914 - Phone
- (850) 215-6230
- Fax
- (850) 215-6235
- NPI assigned
- Dec 14, 2005
- 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 | PY6921 | FL | Primary |
Addresses
Primary practice location
2680 Chapman Dr
Panama City, FL 32405-4914
Mailing address
PO Box 19135
Panama City Beach, FL 32417-1035
Phone (850) 215-6230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74136 | Other | FL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY6921 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391644800000",
"number": "1831174622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19135",
"city": "PANAMA CITY BEACH",
"state": "FL",
"postal_code": "324171035",
"telephone_number": "850-215-6230",
"fax_number": "850-215-6235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2680 CHAPMAN DR",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324054914",
"telephone_number": "850-215-6230",
"fax_number": "850-215-6235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRITSOS",
"first_name": "PAUL",
"name_prefix": "Mr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-14",
"last_updated": "2014-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY6921",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "74136",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.