DR. GEORGE V KOMARIDIS (PH.D.. LP) – Clinical Psychologist, NPI 1124297213

DR. GEORGE V KOMARIDIS (PH.D.. LP) is a healthcare provider. based in Mankato, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. LP. They hold a License No. LP1673 (MN). The NPI Number for DR. GEORGE V KOMARIDIS (PH.D.. LP) is 1124297213

Main info

Male
Sole Proprietor
57 Years Of Experience
Accepts Medicare Assignment
Name
DR. GEORGE V KOMARIDIS (PH.D.. LP)
NPI
1124297213
Phone
(507) 345-4679
Address
11 CIVIC CENTER PLZ STE 205
Enumeration Date
22 February 2008
Last Update Date
29 November 2023

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
5073454679
Graduation Year
1969 (57 years ago)
PAC ID
7719124544
Group Practice PAC ID
3476790296
Professional Enrollment ID
I20130515000189
Address ID
MN560017718MA11XXXPLZX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for DR. GEORGE V KOMARIDIS (PH.D.. LP)

  • 11 CIVIC CENTER PLZ STE 205

    MANKATO, MN 560017718

    Phone: (507) 345-4679

    Fax: (507) 345-8685

    Type: Mailing

  • Civic Center Plaza, Mankato, Blue Earth County, Minnesota, 56001, United States

    SUITE 2090

    MANKATO, MN 560017781

    Phone: (507) 345-4679

    Fax: (507) 345-8685

    Type: Mailing

  • 11 CIVIC CENTER PLZ STE 2090

    MANKATO, MN 560017710

    Phone: (507) 345-4679

    Fax: (507) 345-8685

    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: 2013-05-15

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
I20130515000189IClinical PsychologistMNTBD

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 hour19619$0
View full utilization report →

Insurance plans in this area (ZIP 56001)

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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: 3476790296View full group profile
NameSpecialtyState
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What NPI should I save for DR. GEORGE V KOMARIDIS (PH.D.. LP)?
Save NPI 1124297213 if you need a stable reference for DR. GEORGE V KOMARIDIS (PH.D.. LP).
Is DR. GEORGE V KOMARIDIS (PH.D.. LP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does DR. GEORGE V KOMARIDIS (PH.D.. LP) work in?
You can think of DR. GEORGE V KOMARIDIS (PH.D.. LP) as practicing within Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does DR. GEORGE V KOMARIDIS (PH.D.. LP) practice in Minnesota?
You will see Mankato, Minnesota on file for DR. GEORGE V KOMARIDIS (PH.D.. LP) alongside any extra practice locations.
What if Mankato, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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