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DR. KENNETH HARTLINE PSY.D.
NPI 1114472180
Clinical Neuropsychologist in Los Angeles, CA

Active since August 19, 2016PECOS EnrolledAccepts Medicare Assignment
444 S SAN VICENTE BLVD STE 103, LOS ANGELES, CA 90048(310) 423-9722 Get Directions Write a Review

NPPES record last updated: November 12, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 12, 2025, Aug 19, 2016 (2 updates tracked since 2016).

About Dr. Kenneth Hartline Psy.d. NPPES

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

DR. KENNETH HARTLINE PSY.D. (NPI 1114472180) is an individual clinical neuropsychologist in Los Angeles, California, licensed in California (PSY28449) and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1114472180
Entity TypeIndividualMale
Primary Taxonomy103G00000X
Provider Legal NameDR. KENNETH HARTLINECredential: PSY.D.
Location Address444 S SAN VICENTE BLVD STE 103Los Angeles, CA 90048-4169
Mailing Address4140 W 190th StTorrance, CA 90504-5513
Phone(310) 423-9722
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateAugust 19, 2016
Last NPPES UpdateNovember 12, 20252 updates tracked since enumeration
NPPES CertifiedNovember 12, 2025
✔ NPI 1114472180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in CA · PSY28449
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.
444 S SAN VICENTE BLVD STE 103, Los Angeles, CA 90048
Open in Google Maps ↗

Secondary Practice Locations 2

Location 18700 Beverly Blvd Ste 7409West Hollywood, CA 90048-1804 · Phone (310) 423-9722
Location 22070 Century Park E Ste P456Los Angeles, CA 90067-1907 · Phone (310) 423-9722

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kenneth Hartline Psy.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 ID4486146651
PECOS Enrollment IDI20251125001209
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 Billing Reassignments

2

Medicare enrollment records show Kenneth Hartline reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cedars-Sinai Medical Care Foundation
0.2 mi
Anesthesiology
8700 BEVERLY BLVD STE SB-290
Los Angeles, CA 90048
  • Reassigned Medicare billing, California enrollment
  • 2,118 clinicians in this Medicare group
NPI 1043826720 (310) 423-1447
Cedars-Sinai Medical Center
0.2 mi
General Acute Care Hospital
8700 BEVERLY BLVD
Los Angeles, CA 90048
  • Reassigned Medicare billing, California enrollment
  • 1,001 clinicians in this Medicare group
NPI 1639172372 (323) 866-8600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

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

YI MIAO PHD
Psychologist (Clinical)
444 S SAN VICENTE BLVD STE 103
LOS ANGELES, CA 90048
Los Angeles County (310) 423-9722
VIANNAE CARMONA NELKIN PSYD, BCABA
Clinical Neuropsychologist
444 S SAN VICENTE BLVD STE 103
LOS ANGELES, CA 90048
Los Angeles County (310) 423-9722
DR. ANDREW STEVEN ROSENBLATT PHD
Clinical Neuropsychologist
444 S SAN VICENTE BLVD STE 103
LOS ANGELES, CA 90048
Los Angeles County (310) 423-9722
LIORAH SABBAH PHD
Psychologist (Clinical)
444 S SAN VICENTE BLVD STE 103
LOS ANGELES, CA 90048
Los Angeles County (310) 423-9722
DR. MITZI MICHELLE GONZALES PH.D.
Clinical Neuropsychologist
444 S SAN VICENTE BLVD STE 103
LOS ANGELES, CA 90048
Los Angeles County (310) 423-9722
JUSTIN D MISTERKA PSYD
Psychologist (Clinical)
444 S SAN VICENTE BLVD STE 103
LOS ANGELES, CA 90048
Los Angeles County (310) 423-9722

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 Kenneth Hartline's NPI number?

The NPI number for Kenneth Hartline is 1114472180. It was assigned to this individual provider in the NPPES registry on August 19, 2016.

Where is Kenneth Hartline located?

Kenneth Hartline practices at 444 S San Vicente Blvd Ste 103, Los Angeles, CA 90048. The listed phone number is (310) 423-9722.

What is Kenneth Hartline's specialty?

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

Is Kenneth Hartline enrolled in Medicare?

Yes. Kenneth Hartline 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.

Which organizations bill Medicare for Kenneth Hartline's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Hartline reassigns Medicare benefits to 2 organizations: Cedars-Sinai Medical Care Foundation (Los Angeles, CA) and Cedars-Sinai Medical Center (Los Angeles, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Hartline's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kenneth Hartline was last updated on November 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.