Individual provider Active NPI

Kalynn Gruenfelder, PSY.D.

  • Clinical Psychologist
  • Clearwater, FL
National Provider Identifier
1912625260
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
11571 Issued in FL
Practice address
3000 Gulf to Bay Blvd Ste 300
Clearwater, FL 33759-4304
Phone
(800) 687-1938
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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 11571 FL Primary

Addresses

Primary practice location

3000 Gulf to Bay Blvd Ste 300
Clearwater, FL 33759-4304

Mailing address

3000 Gulf to Bay Blvd Ste 300
Clearwater, FL 33759-4304

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
I20230519001726 FL Practitioner - Clinical Psychologist 3274999016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Coastal Neuropsychology, LLCGroup PAC ID 6406135748, 7 clinicians

Practice addresses (Care Compare)

2415 University Pkwy
Suite 219
Sarasota, FL 34243-2809
Phone (800) 687-1938

3000 Gulf to Bay Blvd
Suite 300
Clearwater, FL 33759-4304
Phone (800) 687-1938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11571FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Neuropsychology, LLC Clinical CurrentSince Apr 1, 2023 Accepting new patients

Locations

3000 Gulf To Bay Blvd
Ste 300
Clearwater, FL 33759
Phone (727) 222-5821

2415 University Pkwy
Ste 2
Sarasota, FL 34243
Phone (800) 687-1938

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": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1912625260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 GULF TO BAY BLVD STE 300",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 GULF TO BAY BLVD STE 300",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594304",
            "telephone_number": "800-687-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUENFELDER",
        "first_name": "KALYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "11571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.