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DR. KERRY LYN GAGNON PHD
NPI 1679056741
Psychologist - Clinical in Philadelphia, PA

Active since September 13, 2018PECOS Enrolled
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104(215) 590-1000 Get Directions Write a Review

NPPES record last updated: August 16, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 16, 2024, Aug 25, 2021, Mar 17, 2021 and 2 more (5 updates tracked since 2018).

About Dr. Kerry Lyn Gagnon Phd NPPES

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

DR. KERRY LYN GAGNON PHD (NPI 1679056741) is an individual clinical provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (PS020150) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679056741
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. KERRY LYN GAGNONCredential: PHD
Location Address3401 CIVIC CENTER BLVDPhiladelphia, PA 19104-4319
Mailing Address5028 Hazel AvePhiladelphia, PA 19143-1622 · (860) 543-9479
Phone(215) 590-1000
Sole ProprietorNo
Enumeration DateSeptember 13, 2018
Last NPPES UpdateAugust 16, 20245 updates tracked since enumeration
NPPES CertifiedAugust 16, 2024
✔ NPI 1679056741 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 PA · PS020150
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 ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X
Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kerry Lyn Gagnon 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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
$180.99 typical visit price
range $59.88 – $180.99
Typical copayment $45.24 (range $14.97 – $45.24)
Most-billed visit code 99205
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

AARON DORFMAN M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - CARDIOLOGY
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4040
MS. NICOLE MARIE KOEPKE CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1944
DR. CASSANDRA ALYS LIGH MD
Surgery (Plastic and Reconstructive Surgery)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-2208
DR. PREETI SOI
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-7555
ROSALIND USHER M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-6336
DR. MATTHEW DAVID SCHREIER MD
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
DR. TERRENCE CALDWELL JR. PHARMD
Pharmacist (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ALYSSA STIEFEL CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000

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 Kerry Gagnon's NPI number?

The NPI number for Kerry Gagnon is 1679056741. It was assigned to this individual provider in the NPPES registry on September 13, 2018.

Where is Kerry Gagnon located?

Kerry Gagnon practices at 3401 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (215) 590-1000.

What is Kerry Gagnon's specialty?

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

Is Kerry Gagnon enrolled in Medicare?

Yes. Kerry Gagnon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kerry Gagnon was last updated on August 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.