DR. JANICE WACHTEL PH.D.
NPI 1134235641
Psychologist - Clinical in Ponte Vedra Beach, FL

Q: What is Janice Wachtel's NPI number?

The NPI number for Janice Wachtel is 1134235641. It was assigned to this individual provider in the NPPES registry on August 21, 2006.

Q: What is Janice Wachtel's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Janice Wachtel was last updated on February 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.

Active since August 21, 2006

100 EXECUTIVE WAY, STE 110, PONTE VEDRA BEACH, FL 32082(904) 834-2235(866) 531-8858 Get Directions Write a Review

NPPES record last updated: February 3, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 3, 2022, Feb 5, 2016 (2 updates tracked since 2016).

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About Dr. Janice Wachtel Ph.d. NPPES

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

DR. JANICE WACHTEL PH.D. (NPI 1134235641) is an individual clinical provider in Ponte Vedra Beach, Florida, licensed in Florida (PY0005827) and active in the NPI registry since August 2006. She is a graduate of Other (1997).

NPPES Registry Identity

NPI1134235641

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JANICE WACHTELCredential: PH.D.

Location Address100 EXECUTIVE WAY, STE 110Ponte Vedra Beach, FL 32082-4753

Mailing Address100 Executive Way, Ste 110Ponte Vedra Beach, FL 32082-4753 · (904) 834-2235 · Fax (866) 531-8858

Phone(904) 834-2235

Fax(866) 531-8858

Sole ProprietorYes

Medical School CMSOtherGraduated 1997

Enumeration DateAugust 21, 2006

Last NPPES UpdateFebruary 3, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 2, 2022

✔ NPI 1134235641 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 FL · PY0005827

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.

100 EXECUTIVE WAY, Ponte Vedra Beach, FL 32082

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Janice Wachtel Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6305010901

PECOS Enrollment IDI20260428000966

Medicare Billing Reassignment

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

Janice Wachtel, Phd, LLC

Same address

Clinical

100 EXECUTIVE WAY,, SUITE 110
Ponte Vedra Beach, FL 32082

Reassigned Medicare billing, Florida enrollment

NPI 1811308901 (904) 834-2235

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 18

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

DEBORAH D. HANNA LCSW

Social Worker (Clinical)

100 EXECUTIVE WAY, SUITE 113
PONTE VEDRA BEACH, FL 32082

St. Johns County (904) 273-6747

NEW CONNECTIONS COUNSELING & CONSULTING LLC

Counselor (Mental Health)

100 EXECUTIVE WAY, #206
PONTE VEDRA BEACH, FL 32082

St. Johns County (904) 273-4094

ETTA F. ETTLINGER LCSW

Social Worker (Clinical)

100 EXECUTIVE WAY, SUITE #110
PONTE VEDRA, FL 32082

St. Johns County (904) 273-4099

NAOMI T. JACOBS, PH.D., P.A.

Psychologist (Clinical)

100 EXECUTIVE WAY, SUITE 207
PONTE VEDRA BEACH, FL 32082

St. Johns County (904) 687-6336

MR. JOSHUA G SCHMITT DPT

Physical Therapist

100 EXECUTIVE WAY, SUITE 109
PONTE VEDRA BEACH, FL 32082

St. Johns County (904) 543-9011

CORA HEALTH SERVICES INC.

Clinic/Center (Rehabilitation)

100 EXECUTIVE WAY, SUITE 109
PONTE VEDRA BEACH, FL 32082

St. Johns County (904) 543-9011

NAOMI JACOBS PH.D.

Psychologist (Clinical)

100 EXECUTIVE WAY, SUITE 207
PONTE VEDRA BEACH, FL 32082

St. Johns County (904) 687-6336

NATALIE CLEM

Physical Therapy Assistant

100 EXECUTIVE WAY, SUITE 109
PONTE VEDRA, FL 32082

St. Johns County (904) 543-9011

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 Janice Wachtel's NPI number?

The NPI number for Janice Wachtel is 1134235641. It was assigned to this individual provider in the NPPES registry on August 21, 2006.

Where is Janice Wachtel located?

Janice Wachtel practices at 100 Executive Way Ste 110, Ponte Vedra Beach, FL 32082. The listed phone number is (904) 834-2235.

What is Janice Wachtel's specialty?

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

Is Janice Wachtel enrolled in Medicare?

Yes. Janice Wachtel is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Janice Wachtel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Janice Wachtel reassigns Medicare benefits to Janice Wachtel, Phd, LLC (Ponte Vedra Beach, FL). 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 Janice Wachtel'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 Janice Wachtel was last updated on February 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.