KRISTOPHER J OLSEN (PHD) – Clinical Psychologist, NPI 1083764492

KRISTOPHER J OLSEN (PHD) is a healthcare provider. based in Melbourne, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. PY0004859 (FL). The NPI Number for KRISTOPHER J OLSEN (PHD) is 1083764492

Main info

Male
Sole Proprietor
35 Years Of Experience
Accepts Medicare Assignment
Name
KRISTOPHER J OLSEN (PHD)
NPI
1083764492
Phone
(321) 751-1925
Address
6767 N WICKHAM RD
Enumeration Date
11 January 2007
Last Update Date
12 September 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3217511925
Graduation Year
1991 (35 years ago)
PAC ID
7012174808
Group Practice PAC ID
9638078025
Professional Enrollment ID
I20120207000071
Address ID
FL329402025ME6767XRDXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

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Provider Addresses for KRISTOPHER J OLSEN (PHD)

  • North Wickham Road, Melbourne, Brevard County, Florida, 32940, United States

    SUITE 306

    MELBOURNE, FL 329402031

    Phone: (321) 751-1925

    Fax: (321) 751-9261

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-02-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120207000071IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour47759$0
90791Psychiatric diagnostic evaluation2825$0
View full utilization report →

Insurance plans in this area (ZIP 32940)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638078025View full group profile
NameSpecialtyState
Nurse PractitionerFL
Clinical PsychologistFL
Clinical PsychologistFL
P S Y C H I A T R YFL
-FL
Mental Health CounselorFL
Clinical PsychologistFL
-FL

Reviews

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Frequently asked questions

Does KRISTOPHER J OLSEN (PHD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KRISTOPHER J OLSEN (PHD) uses 1083764492.
Can I rely on KRISTOPHER J OLSEN (PHD) being an active provider?
As of the registry snapshot, KRISTOPHER J OLSEN (PHD) is marked active.
What taxonomy line describes KRISTOPHER J OLSEN (PHD)?
For research purposes, treat KRISTOPHER J OLSEN (PHD) as Clinical Psychologist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for KRISTOPHER J OLSEN (PHD)?
KRISTOPHER J OLSEN (PHD)'s geographic hint is Melbourne, Florida in our summary view.
Is the information about KRISTOPHER J OLSEN (PHD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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