Individual provider Active NPI

Sarah Mailander Dyer, PHD

  • Clinical Neuropsychologist
  • Belleville, IL
National Provider Identifier
1043877475
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
071010027 Issued in IL
Practice address
900 Royal Heights Rd Ste 14
Belleville, IL 62226-5457
Phone
(618) 744-7373
Fax
(618) 744-7373
NPI assigned
May 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 20043233A IN
Psychologist 103T00000X 071010027 IL
Psychologist 103T00000X 20043233A IN
Clinical Neuropsychologist 103G00000X 071010027 IL Primary

Addresses

Primary practice location

900 Royal Heights Rd Ste 14
Belleville, IL 62226-5457

Mailing address

900 Royal Heights Rd Ste 14
Belleville, IL 62226-5457
Phone (618) 744-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220202000969 IL Practitioner - Clinical Psychologist 9638562382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4505 N Illinois St
Suite 7
Swansea, IL 62226-1500
Phone (618) 680-0317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071010027ILMDClinical Neuropsychologist
20043233AINMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Amethyst Neuropsychology PLLC Clinical Neuropsychologist CurrentSince Nov 1, 2024 Accepting new patients
Hessed Psychological Services LLC Clinical Neuropsychologist CurrentSince Oct 29, 2021 Accepting new patients

Locations

2580 Foxfield Rd
Ste 201
St Charles, IL 60174
Phone (331) 707-4031

4505 N Illinois St
Ste 7
Swansea, IL 62226
Phone (618) 680-0317

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1043877475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROYAL HEIGHTS RD STE 14",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265457",
            "telephone_number": "618-744-7373",
            "fax_number": "618-744-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROYAL HEIGHTS RD STE 14",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265457",
            "telephone_number": "618-744-7373",
            "fax_number": "618-744-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "SARAH",
        "middle_name": "MAILANDER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20043233A",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071010027",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20043233A",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071010027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.