KELLY ELIZABETH DERAGON PSYD
NPI 1346087301
Psychologist - Clinical in Providence, RI

Q: What is Kelly Deragon's NPI number?

The NPI number for Kelly Deragon is 1346087301. It was assigned to this individual provider in the NPPES registry on July 9, 2024.

Q: What is Kelly Deragon'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 Kelly Deragon was last updated on October 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 July 09, 2024PECOS EnrolledAccepts Medicare Assignment

1 RICHMOND SQ, PROVIDENCE, RI 02906(401) 309-1844 Get Directions Write a Review

NPPES record last updated: October 10, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 10, 2024, Jul 9, 2024 (2 updates tracked since 2024).

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About Kelly Elizabeth Deragon Psyd NPPES

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

KELLY ELIZABETH DERAGON PSYD (NPI 1346087301) is an individual clinical provider in Providence, Rhode Island, licensed in Rhode Island (PS02305) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1346087301

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameKELLY ELIZABETH DERAGONCredential: PSYD

Location Address1 RICHMOND SQProvidence, RI 02906-5139

Mailing Address1 Richmond SqProvidence, RI 02906-5139

Phone(401) 309-1844

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 9, 2024

Last NPPES UpdateOctober 10, 20242 updates tracked since enumeration

NPPES CertifiedOctober 10, 2024

✔ NPI 1346087301 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 RI · PS02305

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.

1 RICHMOND SQ, Providence, RI 02906

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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 and accepts Medicare assignment

Kelly Elizabeth Deragon Psyd 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 ID3476081175

PECOS Enrollment IDI20250108003559

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 Kelly Deragon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Child And Family Psychiatry, Inc.

4.8 mi

Psychiatry

1035 POST RD
Warwick, RI 02888

Reassigned Medicare billing, Rhode Island enrollment
158 clinicians in this Medicare group

NPI 1760863229 (401) 785-0040

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 02906 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

$177.03 typical visit price

range $58.57 – $177.03

Typical copayment $44.25 (range $14.64 – $44.25)

Most-billed visit code 99205

Established Patient

$103.10 typical visit price

range $18.92 – $144.38

Typical copayment $25.77 (range $4.73 – $36.09)

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.

Other Providers at the Same Location NPPES 20

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

CHANTA BRYAN LICSW

Social Worker (Clinical)

1 RICHMOND SQ
PROVIDENCE, RI 02906

Providence County (401) 213-1381

ANGELA RUDNER PSYCHOTHERAPY LLC

Social Worker (Clinical)

1 RICHMOND SQ, STE152 E
PROVIDENCE, RI 02906

Providence County (401) 573-9905

MRS. VILNA I. TEJEDA MSW, LICSW

Social Worker (Clinical)

1 RICHMOND SQ
PROVIDENCE, RI 02906

Providence County (401) 288-1002

PETER D LEE LICSW

Social Worker (Clinical)

1 RICHMOND SQ, SUITE 109-C
PROVIDENCE, RI 02906

Providence County (401) 451-6474

MR. DANIEL M EVEN

Social Worker (Clinical)

1 RICHMOND SQ, SUITE 122C
PROVIDENCE, RI 02906

Providence County (401) 454-2890

ANAIT AZARIAN PH.D.

Psychologist (Clinical)

1 RICHMOND SQ, 102K
PROVIDENCE, RI 02906

Providence County (401) 751-3281

RISA GUTTMAN-KORNWITZ

Occupational Therapist

1 RICHMOND SQ, SUITE 220 A-W
PROVIDENCE, RI 02906

Providence County (401) 369-8443

MS. JANE G OFARRELL LICSW

Social Worker (Clinical)

1 RICHMOND SQ, SUITE 126C
PROVIDENCE, RI 02906

Providence County (401) 369-1337

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 Kelly Deragon's NPI number?

The NPI number for Kelly Deragon is 1346087301. It was assigned to this individual provider in the NPPES registry on July 9, 2024.

Where is Kelly Deragon located?

Kelly Deragon practices at 1 Richmond Sq, Providence, RI 02906. The listed phone number is (401) 309-1844.

What is Kelly Deragon's specialty?

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

Is Kelly Deragon enrolled in Medicare?

Yes. Kelly Deragon 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 organization bills Medicare for Kelly Deragon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Deragon reassigns Medicare benefits to Child And Family Psychiatry, Inc. (Warwick, RI). 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 Kelly Deragon'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 Kelly Deragon was last updated on October 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.