DR. KISHA NICOLE BAZELAIS (PHD) – Counseling Psychologist, NPI 1841637063
Counseling Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,462 CLINICAL PSYCHOLOGIST in NY
Provider Addresses for DR. KISHA NICOLE BAZELAIS (PHD)
9621 W ELM LN
MIRAMAR, FL 330252328
Phone: (347) 743-4392
Type: Mailing
275 NORTH ST
HARRISON, NY 105281140
Phone: (914) 925-5489
Type: Mailing
7901 4TH ST N # 8939
ST PETERSBURG, FL 337024305
Phone: (305) 676-7347
Type: Location
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: 2025-06-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250616002296 | I | Clinical Psychologist | FL | TBD |
| I20250618003590 | I | Clinical Psychologist | NY | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33025)
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