Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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

Active since April 04, 2006PECOS EnrolledAccepts Medicare Assignment
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: August 16, 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 and is a graduate of University Of Florida College Of Medicine (1984).

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
Fax(404) 880-0133
Sole ProprietorNo
Medical School CMSUniversity Of Florida College Of MedicineGraduated 1984
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

Other Identifiers 1

Medicaid00423178AGA

Accepted Insurance

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

Gary Santavicca Phd 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 ID4688755747
PECOS Enrollment IDI20080115000140
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.

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 system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

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 37 days 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.