NPIMap

Individual provider Active NPI

Susan Joanna Ireland, PH.D.

  • Clinical Neuropsychologist
  • Miami, FL
National Provider Identifier
1154547164
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY 5603 Issued in FL
Practice address
1611 NW 12TH Ave
Rehabilitation Hospital Center
Miami, FL 33136-1005
Phone
(305) 585-1267
Fax
(305) 355-4715
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY5603 FL
Clinical Psychologist 103TC0700X PY 5603 FL
Health Service Psychologist 103TH0100X PY 5603 FL
Group Psychotherapy Psychologist 103TP2701X PY 5603 FL
Rehabilitation Psychologist 103TR0400X PY 5603 FL
Clinical Neuropsychologist 103G00000X PY 5603 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Rehabilitation Hospital Center
Miami, FL 33136-1005

Mailing address

430 NE 52ND St
Miami, FL 33137-3031
Phone (305) 546-7674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000072 FL Practitioner - Clinical Psychologist 0345371811 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.01 of 100Reported as group
Quality
72.99
Promoting interoperability
82
Improvement activities
40
Cost
78.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY 5603FLMDRehabilitation Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 23, 2019 Accepting new patients
Public Health Trust of Miami Dade County Florida Current Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince May 20, 2010 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince May 20, 2010 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 23, 2019 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 23, 2019 Accepting new patients
Public Health Trust of Miami Dade County Florida Past Accepting new patients

Locations

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1695 NW 9th Ave
Miami, FL 33136
Phone (305) 355-7147

20201 NW 37th Ave
Opa Locka, FL 33056
Phone (786) 466-2700

15055 NW 27th Ave
Opa Locka, FL 33054
Phone (786) 466-2701

Organizations & group practices 7

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1154547164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 NE 52ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373031",
            "telephone_number": "305-546-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "REHABILITATION HOSPITAL CENTER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-1267",
            "fax_number": "305-355-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRELAND",
        "first_name": "SUSAN",
        "middle_name": "JOANNA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5603",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 5603",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "FL",
            "license": "PY 5603",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "FL",
            "license": "PY 5603",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "FL",
            "license": "PY 5603",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY 5603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.