Individual provider Active NPI

Cara J. Haynes, PSYD

  • Clinical Psychologist
  • Milwaukee, WI
National Provider Identifier
1093597023
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
167176 Issued in KY
Practice address
2675 N Mayfair Rd Ste 400
Milwaukee, WI 53226-1305
Phone
(414) 763-6910
Fax
(414) 763-6911
NPI assigned
Oct 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 167176 KY Primary

Addresses

Primary practice location

2675 N Mayfair Rd Ste 400
Milwaukee, WI 53226-1305

Mailing address

7984 New la Grange Rd
Louisville, KY 40222-4718
Phone (502) 426-2777

Other practice location 1

7984 New La Grange Rd
Louisville, KY 40222-4718
Phone (502) 426-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240703001602 WI Practitioner - Clinical Psychologist 0345784195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Frontiers Psychiatric SCGroup PAC ID 7416201058, 9 clinicians

Practice addresses (Care Compare)

2675 N Mayfair Rd
Suite 400
Milwaukee, WI 53226-1305
Phone (414) 763-6910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
167176KYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Frontiers Psychiatric SC CurrentSince Jun 19, 2024 Accepting new patients
New Frontiers TMS LLC CurrentSince Jun 19, 2024 Accepting new patients

Locations

2675 N Mayfair Rd
Ste 400
Milwaukee, WI 53226
Phone (414) 350-2449

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": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1093597023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7984 NEW LA GRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224718",
            "telephone_number": "502-426-2777",
            "fax_number": "502-426-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 N MAYFAIR RD STE 400",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261305",
            "telephone_number": "414-763-6910",
            "fax_number": "414-763-6911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7984 New La Grange Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402224718",
            "country_code": "US",
            "telephone_number": "502-426-2777",
            "fax_number": "502-426-2776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "CARA",
        "middle_name": "J.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "167176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.