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GARY SANTAVICCA PHD
NPI 1124080395
Psychologist - Clinical in Atlanta, GA

Active since April 04, 2006PECOS Enrolled
340 BLVD NE, STE 640, ATLANTA, GA 30312(404) 653-1117(404) 880-0133 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Gary Santavicca Phd NPPES

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

GARY SANTAVICCA PHD (NPI 1124080395) is an individual clinical provider in Atlanta, Georgia, licensed in Georgia (1224) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124080395
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameGARY SANTAVICCACredential: PHD
Location Address340 BLVD NE, STE 640Atlanta, GA 30312
Mailing Address340 Blvd Ne, Ste 640Atlanta, GA 30312 · (404) 653-1117 · Fax (404) 880-0133
Phone(404) 653-1117
Fax(404) 880-0133
Sole ProprietorNo
Enumeration DateApril 4, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1124080395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in GA · 1224
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
340 BLVD NE, Atlanta, GA 30312
Open in Google Maps ↗

Other Identifiers 1

Medicaid00423178AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gary Santavicca Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Gary Santavicca reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gary Santavicca, Ph.D. And Associates
Same address
Psychologist
340 BOULEVARD NE, SUITE 640
Atlanta, GA 30312
  • Reassigned Medicare billing, Georgia enrollment
NPI 1518171222 (404) 653-1117

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30312 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$172.43 typical visit price
range $56.84 – $172.43
Typical copayment $43.10 (range $14.21 – $43.10)
Most-billed visit code 99205
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Gary Santavicca's NPI number?

The NPI number for Gary Santavicca is 1124080395. It was assigned to this individual provider in the NPPES registry on April 4, 2006.

Where is Gary Santavicca located?

Gary Santavicca practices at 340 Blvd NE Ste 640, Atlanta, GA 30312. The listed phone number is (404) 653-1117.

What is Gary Santavicca's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Gary Santavicca enrolled in Medicare?

Yes. Gary Santavicca is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Gary Santavicca's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gary Santavicca reassigns Medicare benefits to Gary Santavicca, Ph.D. And Associates (Atlanta, GA). The 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 Gary Santavicca's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gary Santavicca accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Gary Santavicca as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gary Santavicca was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.