Dimitrios Hatzivlassiou, MD, PHD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME 84252 Issued in FL

Practice address

2400 S Hwy 27
Suite 4309
Clermont, FL 34711-6816

Phone

(352) 353-0557

NPI assigned

Apr 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCR Health IncGroup PAC ID 7214847995, 132 clinicians

Health Care Center for the Homeless IncGroup PAC ID 6103895107, 51 clinicians

Ace Behavioral Health LLCGroup PAC ID 2668984675, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Ace Behavioral Health LLC

  • Psychiatry Physician
  • Tampa, FL
  • NPI 1841094885
  Medicare reassignment Care Compare group NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment Care Compare group NPD
• Health Care Center for the Homeless Inc

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
  • NPI 1235213216
  Medicare reassignment Care Compare group
• Citrus County Rural Health Inc

  • Federally Qualified Health Center (FQHC)
  • Crystal River, FL
  • NPI 1740931831
  Medicare reassignment NPD
• Coastal Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fernandina Beach, FL
  • NPI 1851131874
  Medicare reassignment
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• Lifestream Behavioral Center Inc

  • Primary Care Clinic/Center
  • Leesburg, FL
  • NPI 1659613776
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1992769400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S HWY 27",
            "address_2": "SUITE 4309",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116816",
            "telephone_number": "352-353-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S HWY 27",
            "address_2": "SUITE 4309",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116816",
            "telephone_number": "352-353-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATZIVLASSIOU",
        "first_name": "DIMITRIOS",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME 84252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "03387",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267232400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilna Harris
• Harvest House Community Development Corp.
• Harvest House Community Development Corporation
• Amy Marie Harvick, ARNP
• Laila Siddika Hassan
• Mary Elizabeth Francis Hauer
• Savannah Hawthorne, PTA/L
• Haydex and Partners, LLC
• Drena Marie Hayes, APRN
• Teresa A Hayes

• Psychiatry Physician in Clermont, FL
• Providers in Clermont, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.

Verify at the official NPI Registry.