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TANYA PELLETTIERE PHD
NPI 1336223387
Psychologist - Clinical in Syracuse, NY

Active since October 25, 2006PECOS Enrolled
4317 E GENESEE ST STE 205, SYRACUSE, NY 13214(315) 430-8040 Get Directions Write a Review

NPPES record last updated: January 7, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tanya Pellettiere Phd NPPES

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

TANYA PELLETTIERE PHD (NPI 1336223387) is an individual clinical provider in Syracuse, New York, licensed in New York (015070-1) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336223387
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameTANYA PELLETTIERECredential: PHD
Location Address4317 E GENESEE ST STE 205Syracuse, NY 13214-2200
Mailing Address4317 E Genesee St Ste 205Syracuse, NY 13214-2200 · (315) 430-8040
Phone(315) 430-8040
Sole ProprietorNo
Enumeration DateOctober 25, 2006
Last NPPES UpdateJanuary 7, 2020
✔ NPI 1336223387 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 NY · 015070-1
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.
4317 E GENESEE ST STE 205, Syracuse, NY 13214
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Other Identifiers 1

Medicaid02332456NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tanya Pellettiere 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 Reassignments

2

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

Suny Health Science Center At Syracuse
3.7 mi
General Acute Care Hospital
750 EAST ADAMS STREET
Syracuse, NY 13210
  • Reassigned Medicare billing, New York enrollment
  • 271 clinicians in this Medicare group
NPI 1184974529 (315) 464-6530
Thrive Counseling LLC
420 mi
Mental Health
1000 JEFFERSON ST STE 2C
Lynchburg, VA 24504
  • Reassigned Medicare billing, Virginia enrollment
  • 302 clinicians in this Medicare group
NPI 1215181300 (855) 284-7483

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 13214 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
$166.88 typical visit price
range $54.87 – $166.88
Typical copayment $41.72 (range $13.71 – $41.72)
Most-billed visit code 99205
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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 Tanya Pellettiere's NPI number?

The NPI number for Tanya Pellettiere is 1336223387. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Where is Tanya Pellettiere located?

Tanya Pellettiere practices at 4317 E Genesee St Ste 205, Syracuse, NY 13214. The listed phone number is (315) 430-8040.

What is Tanya Pellettiere's specialty?

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

Is Tanya Pellettiere enrolled in Medicare?

Yes. Tanya Pellettiere is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Tanya Pellettiere's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tanya Pellettiere reassigns Medicare benefits to 2 organizations: Suny Health Science Center At Syracuse (Syracuse, NY) and Thrive Counseling LLC (Lynchburg, VA). 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 Tanya Pellettiere'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 Tanya Pellettiere was last updated on January 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.