npidexNPI registry + Medicare data

ALAN ICKOWITZ, PSY.D.

Clinical Psychologist · DUNEDIN, FL

Individual Active Opted out of Medicare NPI 1083732200

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Clinical Psychologist103TC0700X✓PY5649FL
Psychologist103T00000XPY5649FL
Addiction (Substance Use Disorder) Psychologist103TA0400XPY5649FL

Medicare eligibility

Part B
Yes
DME
Yes
Home health
No
Power mobility
No
Hospice
No

Opted out of Medicare (Clinical Psychologist), effective 2014-01-01 through 2028-01-01.

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.