DR. THEODORA KANELLOPOULOS PH.D.
NPI 1083091870
Clinical Neuropsychologist in White Plains, NY

Active since April 30, 2015PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
21 BLOOMINGDALE RD, 7 SOUTH, WHITE PLAINS, NY 10605(917) 886-4779 Get Directions Write a Review

NPPES record last updated: April 30, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Theodora Kanellopoulos Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THEODORA KANELLOPOULOS PH.D. (NPI 1083091870) is an individual clinical neuropsychologist in White Plains, New York, licensed in New York (021101) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1083091870
Entity TypeIndividualFemale
Primary Taxonomy103G00000X
Provider Legal NameDR. THEODORA KANELLOPOULOSCredential: PH.D.
Location Address21 BLOOMINGDALE RD, 7 SOUTHWhite Plains, NY 10605-1504
Mailing Address21 Bloomingdale Rd, 7 SouthWhite Plains, NY 10605-1504 · (917) 886-4779
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateApril 30, 2015
NPI 1083091870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License Licensed in NY · 021101
Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 021101 (NY)
21 BLOOMINGDALE RD, White Plains, NY 10605

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Theodora Kanellopoulos Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860791423
PECOS Enrollment IDI20160503001245
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.8
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
21 BLOOMINGDALE RD
WHITE PLAINS, NY 10605
Psychologist
21 BLOOMINGDALE RD
WHITE PLAINS, NY 10605
Nurse Anesthetist, Certified Registered
21 BLOOMINGDALE RD
WHITE PLAINS, NY 10605
Psychologist (Clinical)
21 BLOOMINGDALE RD
WHITE PLAINS, NY 10605
Nurse Practitioner (Psychiatric/Mental Health)
21 BLOOMINGDALE RD
WHITE PLAINS, NY 10605
Psychiatry & Neurology (Psychiatry)
21 BLOOMINGDALE RD
WHITE PLAINS, NY 10605
Pathology (Blood Banking & Transfusion Medicine)
21 BLOOMINGDALE RD, WALL BUILDING
WHITE PLAINS, NY 10605
Psychologist (Clinical)
21 BLOOMINGDALE RD
WHITE PLAINS, NY 10605

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodora Kanellopoulos's NPI number?

The NPI number for Theodora Kanellopoulos is 1083091870. It was assigned to this individual provider in the NPPES registry on April 30, 2015.

Where is Theodora Kanellopoulos located?

Theodora Kanellopoulos practices at 21 Bloomingdale Rd 7 South, White Plains, NY 10605. The listed phone number is (917) 886-4779.

What is Theodora Kanellopoulos's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Theodora Kanellopoulos enrolled in Medicare?

Yes. Theodora Kanellopoulos is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Theodora Kanellopoulos was last updated on April 30, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.