Kelly M. Stanek, PHD
NPI 1063862639ActiveIndividual· Clinical Neuropsychologist· Augusta, GA
Clinical Neuropsychologist (PHD) with Wellstar Medical Group LLC, practicing in Augusta, Georgia. Medicare paid $12,628 for services to 51 patients in 2024. Lists Wellstar McG Health, Affiliated With Med Col as a hospital affiliation.
Overview
| NPI | 1063862639 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Jun 15, 2016 |
| Last updated in NPPES | Aug 4, 2023 |
| Certified by provider | Aug 4, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinical Neuropsychologist Primary | 103G00000X | PSY004125 | GA |
| Clinical Neuropsychologist | 103G00000X | 3375-057 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (GA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 51 |
|---|---|
| Services billed | 201 across 3 procedure codes |
| Paid by Medicare | $12,628 |
Education and affiliations
| Graduation year | 2011 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- Wellstar Medical Group LLCMarietta, GA · 3,093 clinicians
Hospital affiliation
- Wellstar McG Health, Affiliated With Med ColAugusta, GA
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