DR. KRISTEN ELAINE HOLDERLE PHD
NPI 1356420939
Psychologist in Pittsford, NY

Active since November 03, 2006PECOS EnrolledAccepts Medicare Assignment
1175 PITTSFORD VICTOR RD, SUITE 100, PITTSFORD, NY 14534(585) 797-7084(844) 626-2450 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 5, 2023, Nov 12, 2020 (2 updates tracked since 2020).

About Dr. Kristen Elaine Holderle Phd NPPES

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

DR. KRISTEN ELAINE HOLDERLE PHD (NPI 1356420939) is an individual psychologist in Pittsford, New York, licensed in New York (016808) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1356420939
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. KRISTEN ELAINE HOLDERLECredential: PHD
Location Address1175 PITTSFORD VICTOR RD, SUITE 100Pittsford, NY 14534-3811
Mailing Address1175 Pittsford Victor Rd, Suite 100Pittsford, NY 14534-3811 · (585) 797-7084 · Fax (844) 626-2450
Fax(844) 626-2450
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateNovember 3, 2006
Last NPPES UpdateJuly 5, 20232 updates tracked since enumeration
NPPES CertifiedNovember 12, 2020
✔ NPI 1356420939 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses✔ Licensed in NY · 016808✔ Licensed in NY · 16808
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1175 PITTSFORD VICTOR RD, Pittsford, NY 14534

Other Names 1

Former Name (1)Kristen Holderle Davidson Phd

Other Identifiers 3

Other18954FCNY · Preferred Care
Other7161860NY · Aetna
OtherP010016808NY · Excellus Rochester Region

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

Dr. Kristen Elaine Holderle 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 ID7416231477
PECOS Enrollment IDI20170313000406
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

3

Medicare enrollment records show Kristen Holderle reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Primary Care
905 CULVER RD
Rochester, NY 14609
  • Reassigned Medicare billing, New York enrollment
  • 26 clinicians in this Medicare group
General Practice
625 ELMWOOD AVE, BOX 683
Rochester, NY 14620
  • Reassigned Medicare billing, New York enrollment
  • 1,624 clinicians in this Medicare group
Psychiatry
300 CRITTENDEN BLVD
Rochester, NY 14642
  • Reassigned Medicare billing, New York enrollment
  • 191 clinicians in this Medicare group

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

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 Kristen Holderle's NPI number?

The NPI number for Kristen Holderle is 1356420939. It was assigned to this individual provider in the NPPES registry on November 3, 2006. The provider is also known as Kristen Holderle Davidson Phd.

Where is Kristen Holderle located?

Kristen Holderle practices at 1175 Pittsford Victor Rd Suite 100, Pittsford, NY 14534. The listed phone number is (585) 797-7084.

What is Kristen Holderle's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kristen Holderle enrolled in Medicare?

Yes. Kristen Holderle 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 organizations bill Medicare for Kristen Holderle's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristen Holderle reassigns Medicare benefits to 3 organizations: Adult Complex Care Center (Rochester, NY), University Of Rochester (Rochester, NY) and University Of Rochester Department Of Psychiatry Clinical Group (Rochester, NY). 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 Kristen Holderle'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 Kristen Holderle was last updated on July 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.