Dr Jack Kitaeff, PHD - Medicare Psychologist in Fairfax, VA

Dr Jack Kitaeff, PHD is a medicare enrolled "Psychologist - Clinical" provider in Fairfax, Virginia. He went to University Of Mississippi School Of Medicine and graduated in 1978 and has 46 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Clinical Psychology Services Pc and his current practice location is 10560 Main St, Suite 518, Fairfax, Virginia. You can reach out to his office (for appointments etc.) via phone at (703) 349-2999.

Dr Jack Kitaeff is licensed to practice in Virginia (license number 1070) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1518300201.

Contact Information

Dr Jack Kitaeff, PHD
10560 Main St, Suite 518,
Fairfax, VA 22030-7182
(703) 349-2999
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDr Jack Kitaeff
GenderMale
SpecialityClinical Psychologist
Experience46 Years
Location10560 Main St, Fairfax, Virginia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Jack Kitaeff attended and graduated from University Of Mississippi School Of Medicine in 1978
  NPI Data:
  • NPI Number: 1518300201
  • Provider Enumeration Date: 04/11/2013
  • Last Update Date: 09/29/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 6608132261
  • Enrollment ID: I20171114003674

Medical Identifiers

Medical identifiers for Dr Jack Kitaeff such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1518300201NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 1070 (Virginia)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Clinical Psychology Services Pc54967187939

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jack Kitaeff allows following entities to bill medicare on his behalf.
Entity NameClinical Psychology Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1194818054
PECOS PAC ID: 5496718793
Enrollment ID: O20041108000889

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Kitaeff is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Jack Kitaeff, PHD
9020 Fort Craig Dr,
Burke, VA 22015-2115

Ph: (703) 501-0129
Dr Jack Kitaeff, PHD
10560 Main St, Suite 518,
Fairfax, VA 22030-7182

Ph: (703) 349-2999

Reviews and Comments


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