Dr Jack Kitaeff, PHD in Fairfax, VA - Medicare Clinical Psychologist Provider

Dr Jack Kitaeff, PHD is a medicare enrolled "Psychologist - Clinical" provider in Fairfax, Virginia. He went to University Of Mississippi School Of Medicine and graduated in 1978 and has 46 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Clinical Psychology Services Pc and his current practice location is 10560 Main St, Suite 518, Fairfax, Virginia. You can reach out to his office (for appointments etc.) via phone at (703) 349-2999.

Dr Jack Kitaeff is licensed to practice in Virginia (license number 1070) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1518300201.

Contact Information

	Dr Jack Kitaeff, PHD
	10560 Main St, Suite 518, Fairfax, VA 22030-7182
	(703) 349-2999
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Jack Kitaeff
Gender	Male
Speciality	Clinical Psychologist
Experience	46 Years
Location	10560 Main St, Fairfax, Virginia
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Jack Kitaeff attended and graduated from University Of Mississippi School Of Medicine in 1978

NPI Data:

NPI Number: 1518300201
Provider Enumeration Date: 04/11/2013
Last Update Date: 09/29/2016

Medicare PECOS Information:

PECOS PAC ID: 6608132261
Enrollment ID: I20171114003674

Medical Identifiers

Medical identifiers for Dr Jack Kitaeff such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1518300201	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	1070 (Virginia)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Clinical Psychology Services Pc	5496718793	10

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jack Kitaeff allows following entities to bill medicare on his behalf.

Entity Name	Clinical Psychology Services Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194818054 PECOS PAC ID: 5496718793 Enrollment ID: O20041108000889

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Kitaeff is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Jack Kitaeff, PHD 9020 Fort Craig Dr, Burke, VA 22015-2115 Ph: (703) 501-0129	Dr Jack Kitaeff, PHD 10560 Main St, Suite 518, Fairfax, VA 22030-7182 Ph: (703) 349-2999

Reviews and Comments

Psychologist in Fairfax, VA

Katherine Nethercote, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 8270 Willow Oaks Corporate Dr, Fairfax, VA 22031 Phone: 571-423-4900
Adrienne Konstantin, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3925 Blenheim Blvd Ste 53a, Fairfax, VA 22030 Phone: 703-972-2388
Dr. Jennie Lynn Crim, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 10560 Main St Ste 507, Fairfax, VA 22030 Phone: 703-691-1326 Fax: 703-691-3553
Dr. Diane Marie Hoekstra, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 10721 Main St Ste 2350, Fairfax, VA 22030 Phone: 703-591-5912 Fax: 703-581-7210
Kathleen Racz Baker, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 8270 Willow Oaks Corporate Dr, Fairfax, VA 22031 Phone: 703-899-4061
Jennie Song, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 8270 Willow Oaks Corporate Dr, Fairfax, VA 22031 Phone: 571-423-4250
Dr. Sydney Louise Mills, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 11166 Fairfax Blvd Ste 207, Fairfax, VA 22030 Phone: 703-865-4900

Dr Jack Kitaeff, PHD - Medicare Psychologist in Fairfax, VA