BLAISE FORTUNATA (PSYCHOLOGIST) – Psychologist, NPI 1609816636

BLAISE FORTUNATA (PSYCHOLOGIST) is a healthcare provider. based in Hyannis, Massachusetts. specializing in Psychologist. They hold the professional credentials PSYCHOLOGIST. They hold a License No. 8563 (MA). The NPI Number for BLAISE FORTUNATA (PSYCHOLOGIST) is 1609816636

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
BLAISE FORTUNATA (PSYCHOLOGIST)
NPI
1609816636
Phone
(508) 790-3360
Address
460 W MAIN ST
Enumeration Date
7 June 2006
Last Update Date
30 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7076514295
Graduation Year
1998 (28 years ago)
PAC ID
6002826351
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20160210002223

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

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Provider Addresses for BLAISE FORTUNATA (PSYCHOLOGIST)

  • 460, West Main Street, Hyannis, Barnstable, Barnstable County, Massachusetts, 02601, United States

    HYANNIS, MA 026013855

    Phone: (508) 790-3360

    Fax: (508) 790-3378

    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: 2016-02-10

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
I20160210002223IClinical PsychologistCATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02601)

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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: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
Colorectal Surgery (Proctology), General SurgeryLA
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Emergency MedicineCA
-MA
Emergency MedicineCA

Reviews

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Frequently asked questions

Can I use this page to confirm BLAISE FORTUNATA (PSYCHOLOGIST)'s NPI?
Yes. BLAISE FORTUNATA (PSYCHOLOGIST) is listed with NPI 1609816636 in the public NPI dataset.
Is BLAISE FORTUNATA (PSYCHOLOGIST) listed as active for patients and plans?
The listing shows BLAISE FORTUNATA (PSYCHOLOGIST) as active in the NPI system.
What is BLAISE FORTUNATA (PSYCHOLOGIST) best known for clinically?
Directory data describes BLAISE FORTUNATA (PSYCHOLOGIST) with Psychologist. Clinical services aligned with this taxonomy classification.
Where should I expect BLAISE FORTUNATA (PSYCHOLOGIST) on a map?
Expect Hyannis, Massachusetts as a primary anchor for BLAISE FORTUNATA (PSYCHOLOGIST) unless the record lists multiple sites.
Is the information about BLAISE FORTUNATA (PSYCHOLOGIST) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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