KELLY M STANEK (PHD) – Clinical Neuropsychologist, NPI 1063862639
Clinical Neuropsychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
483 CLINICAL PSYCHOLOGIST in GA
Provider Addresses for KELLY M STANEK (PHD)
1120 15TH ST # OR6000
AUGUSTA, GA 309120004
Phone: (706) 721-3813
Type: Mailing
1120 15TH ST
AUGUSTA, GA 309120004
Phone: (706) 721-4581
Type: Location
1313 Fish Hatchery Rd
Madison, WI 537151911
Phone: (608) 252-8000
Type: Location
Augusta University Medical Center, 1120, 15th Street, Augusta, Richmond County, Georgia, 30912, United States
AUGUSTA, GA 309120004
Phone: (706) 721-4581
Type: Mailing
SSM Health Dean Medical Group, 1313, Fish Hatchery Road, Bay Creek, Madison, Dane County, Wisconsin, 53715, United States
MADISON, WI 537151911
Phone: (608) 252-8000
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.
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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: 2017-11-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171103001598 | I | Clinical Psychologist | GA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 96133 | Evaluation of neuropsychological test, each additional hour | 242 | 56 | $0 |
| 96116 | Exam of neurobehavioral status, first hour | 57 | 56 | $0 |
| 96132 | Evaluation of neuropsychological test, first hour | 57 | 56 | $0 |
Insurance plans in this area (ZIP 30912)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHOLOGIST, CLINICAL | WI | 96118 | Neuropsychological testing, interpretation, and report by psychologist or physician per hour | 60 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| - | GA | |
| - | GA | |
| R H E U M A T O L O G Y | MI | |
| Hospitalist, Internal Medicine | GA | |
| Nurse Practitioner | TN | |
| Family Practice | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Hospitalist, Internal Medicine | GA |
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