VICTORIO M. GARDNER PSY.D.
NPI 1376691964
Psychologist - Clinical in Detroit, MI

Q: What is Victorio Gardner's NPI number?

The NPI number for Victorio Gardner is 1376691964. It was assigned to this individual provider in the NPPES registry on January 8, 2007.

Q: What is Victorio Gardner'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 Victorio Gardner was last updated on April 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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 January 08, 2007PECOS EnrolledAccepts Medicare Assignment

2799 W GRAND BLVD, DETROIT, MI 48202(313) 916-2600(313) 874-4677 Get Directions Write a Review

NPPES record last updated: April 14, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Victorio M. Gardner Psy.d. NPPES

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

VICTORIO M. GARDNER PSY.D. (NPI 1376691964) is an individual clinical provider in Detroit, Michigan, licensed in Michigan (6301009431) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Wright State University Boonshoft School Of Medicine (1994).

NPPES Registry Identity

NPI1376691964

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameVICTORIO M. GARDNERCredential: PSY.D.

Location Address2799 W GRAND BLVDDetroit, MI 48202-2608

Mailing Address2799 W Grand BlvdDetroit, MI 48202-2608 · (313) 916-2600

Phone(313) 916-2600

Fax(313) 874-4677

Sole ProprietorNo

Medical School CMSWright State University Boonshoft School Of MedicineGraduated 1994

Enumeration DateJanuary 8, 2007

Last NPPES UpdateApril 14, 2025

NPPES CertifiedApril 14, 2025

✔ NPI 1376691964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MI · 6301009431

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.

Also ListedPsychologistTaxonomy 103T00000X · License 6301009431 (MI)

Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X · License 6301009431 (MI)

2799 W GRAND BLVD, Detroit, MI 48202

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and more.Insurance ›

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

Victorio M. Gardner Psy.d. 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 ID4082947312

PECOS Enrollment IDI20190531000747

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

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

Henry Ford Health System

0.1 mi

Clinical

2799 W GRAND BLVD
Detroit, MI 48202

Reassigned Medicare billing, Michigan enrollment
52 clinicians in this Medicare group

NPI 1114001468 (313) 916-2600

Henry Ford Health Eastwood Behavioral Health

16 mi

Social Worker

37500 GARFIELD RD STE 175
Clinton Township, MI 48036

Reassigned Medicare billing, Michigan enrollment
98 clinicians in this Medicare group

NPI 1396787701 (586) 792-5335

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 48202 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

$177.36 typical visit price

range $58.04 – $177.36

Typical copayment $44.34 (range $14.51 – $44.34)

Most-billed visit code 99205

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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.

HENRY FORD HOSPITAL

General Acute Care Hospital