LISA CHRISTINE PELLEGRIN PH.D.
NPI 1972259489
Psychologist - Clinical in Nashville, TN

Q: What is Lisa Pellegrin's NPI number?

The NPI number for Lisa Pellegrin is 1972259489. It was assigned to this individual provider in the NPPES registry on February 23, 2022.

Q: What is Lisa Pellegrin's specialty?

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

Q: Is Lisa Pellegrin enrolled in Medicare?

No. Lisa Pellegrin has opted out of Medicare through May 12, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Lisa Pellegrin was last updated on February 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 February 23, 2022Opted out of Medicare · through May 12, 2028

1412 17TH AVE S, NASHVILLE, TN 37212(615) 823-3802 Get Directions Write a Review

NPPES record last updated: February 23, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Lisa Christine Pellegrin Ph.d. NPPES

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

LISA CHRISTINE PELLEGRIN PH.D. (NPI 1972259489) is an individual clinical provider in Nashville, Tennessee, licensed in Tennessee (2577) and active in the NPI registry since February 2022. She has opted out of Medicare through May 12, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1972259489

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameLISA CHRISTINE PELLEGRINCredential: PH.D.

Location Address1412 17TH AVE SNashville, TN 37212-2804

Mailing Address1412 17th Ave SNashville, TN 37212-2804 · (615) 823-3802

Phone(615) 823-3802

Sole ProprietorYes

Enumeration DateFebruary 23, 2022

NPPES CertifiedFebruary 17, 2022

✔ NPI 1972259489 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 TN · 2577

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.

1412 17TH AVE S, Nashville, TN 37212

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Lisa Christine Pellegrin Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 12, 2026 through May 12, 2028.

Opt-Out Effective DateMay 12, 2026

Opt-Out In Effect ThroughMay 12, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37212 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

$160.89 typical visit price

range $52.64 – $160.89

Typical copayment $40.22 (range $13.16 – $40.22)

Most-billed visit code 99205

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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

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

TYNYA DAWN PATTON LPC, MHSP

Counselor (Professional)

1412 17TH AVE S
NASHVILLE, TN 37212

Davidson County (615) 310-0246

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 Lisa Pellegrin's NPI number?

The NPI number for Lisa Pellegrin is 1972259489. It was assigned to this individual provider in the NPPES registry on February 23, 2022.

Where is Lisa Pellegrin located?

Lisa Pellegrin practices at 1412 17th Ave S, Nashville, TN 37212. The listed phone number is (615) 823-3802.

What is Lisa Pellegrin's specialty?

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

Is Lisa Pellegrin enrolled in Medicare?

No. Lisa Pellegrin has opted out of Medicare through May 12, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Lisa Pellegrin was last updated on February 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.