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DR. TAMARA MCGILLICUDDY PSYD
NPI 1396513271
Psychologist - Clinical in Elk Grove, CA

Active since December 19, 2023PECOS Enrolled
9324 W STOCKTON BLVD, ELK GROVE, CA 95758(916) 525-6100 Get Directions Write a Review

NPPES record last updated: December 19, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Tamara Mcgillicuddy Psyd NPPES

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

DR. TAMARA MCGILLICUDDY PSYD (NPI 1396513271) is an individual clinical provider in Elk Grove, California, licensed in California (34740) and active in the NPI registry since December 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396513271
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. TAMARA MCGILLICUDDYCredential: PSYD
Location Address9324 W STOCKTON BLVDElk Grove, CA 95758-8012
Mailing Address9324 W Stockton BlvdElk Grove, CA 95758-8012 · (916) 525-6100
Phone(916) 525-6100
Sole ProprietorNo
Enumeration DateDecember 19, 2023
NPPES CertifiedDecember 19, 2023
✔ NPI 1396513271 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 CA · 34740
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.
9324 W STOCKTON BLVD, Elk Grove, CA 95758
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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. Tamara Mcgillicuddy Psyd 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 Reassignment

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

Permanente Medical Group Inc
28 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000

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 95758 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
$180.85 typical visit price
range $60.44 – $180.85
Typical copayment $45.21 (range $15.11 – $45.21)
Most-billed visit code 99205
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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.

Other Providers at the Same Location NPPES 13

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

STEPHANIE KAWAS BARRY
Counselor
9324 W STOCKTON BLVD
ELK GROVE, CA 95758
Sacramento County (916) 525-6154
JIAXIN CHEN APCC
Counselor
9324 W STOCKTON BLVD
ELK GROVE, CA 95758
Sacramento County (916) 525-6100
DR. KENNETH EMERSON ROGERS PSY.D.
Psychologist (Clinical)
9324 W STOCKTON BLVD
ELK GROVE, CA 95758
Sacramento County (916) 478-7716
EMILY MARCH
Counselor (Mental Health)
9324 W STOCKTON BLVD
ELK GROVE, CA 95758
Sacramento County (916) 525-6100
ALEXIS MARIE DE LOS REYES
Counselor (Mental Health)
9324 W STOCKTON BLVD
ELK GROVE, CA 95758
Sacramento County (916) 525-6100
MS. SARAH ROBERTSON LCSW
Social Worker (Clinical)
9324 W STOCKTON BLVD
ELK GROVE, CA 95758
Sacramento County (916) 478-7631
DANNETTE MCCALMAN
Counselor
9324 W STOCKTON BLVD
ELK GROVE, CA 95758
Sacramento County (916) 525-6100
LACY BROWN
Counselor (Mental Health)
9324 W STOCKTON BLVD
ELK GROVE, CA 95758
Sacramento County (916) 525-6100

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 Tamara Mcgillicuddy's NPI number?

The NPI number for Tamara Mcgillicuddy is 1396513271. It was assigned to this individual provider in the NPPES registry on December 19, 2023.

Where is Tamara Mcgillicuddy located?

Tamara Mcgillicuddy practices at 9324 W Stockton Blvd, Elk Grove, CA 95758. The listed phone number is (916) 525-6100.

What is Tamara Mcgillicuddy's specialty?

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

Is Tamara Mcgillicuddy enrolled in Medicare?

Yes. Tamara Mcgillicuddy is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tamara Mcgillicuddy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tamara Mcgillicuddy reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). 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 Tamara Mcgillicuddy'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 Tamara Mcgillicuddy was last updated on December 19, 2023. 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.