Individual provider Active NPI

Colin Sauder, PHD

  • Psychologist
  • Watertown, MA
National Provider Identifier
1104466846
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
11184 Issued in MA
Practice address
521 Mount Auburn St Ste 209
Watertown, MA 02472-4153
Phone
(617) 744-8542
NPI assigned
Jan 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 11184 MA Primary

Addresses

Primary practice location

521 Mount Auburn St Ste 209
Watertown, MA 02472-4153

Mailing address

521 Mount Auburn St Ste 209
Watertown, MA 02472-4153
Phone (617) 744-8542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
11184MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1104466846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 MOUNT AUBURN ST STE 209",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724153",
            "telephone_number": "617-744-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MOUNT AUBURN ST STE 209",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724153",
            "telephone_number": "617-744-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUDER",
        "first_name": "COLIN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "11184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.